T4E Slips: 1  
   Federal slips: 


T4E - Statement of Employment Insurance and Other Benefits


Box Line Description Federal Slip
Notes:
7 Repayment rate (%) 7
14 Total benefits paid 14
15 Regular and other benefits paid 15
17 Employment benefits & support measures paid 17
18 Tax exempt benefits 18
If box 18 includes any employment insurance maternity and parental benefits and provincial parental insurance plan maternity and paternity benefits, please identify and enter the applicable amount (cannot exceed the amount in box 18) (see line 10019 of form T90).
20 Taxable tuition assistance 20
21 Non-taxable tuition assistance 21
22 Income tax deducted 22
23 Quebec income tax deducted 23
24 Non-resident tax deducted 24
26 Overpayment recovered or repaid 26
27 Reversal of federal tax deducted 27
30 Total repayment 30
33 Payments out of the consolidated revenue fund 33
36 Provincial Parental Insurance Plan benefits (included in box 14) 36
37 EI maternity and parental benefits payments (included in box 14) (see line 11905 of your return). 37


Repayment Chart

Fill in this chart if the rate in box 7 is 30% and, on your return, the total of lines 21300 and 23400 plus the amount of registered disability savings plan (RDSP) income repayment included on line 23200, minus the total of lines 11700 and 12500 is more than $76,875.

 
   Amount from box 15 minus the amount from box 30 when present (if negative, enter "0")  1 
   Total of amounts on lines 21300 and 23400 plus the amount of RDSP included on line 23200 of your return, minus the amounts on lines 11700 and 12500  2 
   Line 2 minus $76,875 (if negative, enter "0")  3 
   Amount from line 1 or 3, whichever is less  4 
   Multiply the amount on line 4 by 30% =  5 
 
   Enter the amount from line 4 on lines 23500 and 42200 of your return. However, if you also received Old Age Security benefits and the amount on line 23400 of your return is more than $86,912, complete the chart for line 23500 on the Federal Worksheet.