T1198 Forms: 1  
Federal forms: 

Protected B when completed
 
  Statement of Qualifying Retroactive Lump-Sum Payment  

To the payer:
Fill out this form if you paid a qualifying retroactive lump-sum payment (QRLSP) to an individual (other than a trust) in 1995 or later years. Enter the amount of the QRLSP and its breakdown in the appropriate boxes below. Give the filled out and signed form to the recipient of the QRLSP. If you paid more than one QRLSP to an individual, fill out one form for each QRLSP paid. See the back of this form for details.
Note: The QRLSP income stated on this form has to be included on the recipient's information slip (such as a T4, T4A and T4E).

To the recipient:
The Canada Revenue Agency (CRA) will not reassess your returns for prior years to include this income. However, you can ask the CRA to tax the parts for the prior years as if you received them in those years. You have to include the full payment on the correct line of your return for the year. See the back of this form for details.
NEW: As of February 2025, you can submit your income tax and benefit return electronically even if you are asking for the special tax calculation.

 
Name of recipient Social insurance number (SIN) Year of payment
Description of QRLSP and reasons for payment
Total amount
(principal and interest)		 Total principal
(current and prior years)		 Total interest
(current and prior years)		 Total principal
(prior years only)
68518 68519
                       
Breakdown of principal (box 68519)

Enter the amount of principal that relates to each year that applies in the boxes below. Do not include the interest amount.


40th prior year 32nd prior year 24th prior year 16th prior year 8th prior year
68520 68528 68536 68544 68552
 
39th prior year 31st prior year 23rd prior year 15th prior year 7th prior year
68521 68529 68537 68545 68553
 
38th prior year 30th prior year 22nd prior year 14th prior year 6th prior year
68522 68530 68538 68546 68554
 
37th prior year 29th prior year 21st prior year 13rd prior year 5th prior year
68523 68531 68539 68547 68555
 
36th prior year 28th prior year 20th prior year 12nd prior year 4th prior year
68524 68532 68540 68548 68556
 
35th prior year 27th prior year 19th prior year 11st prior year 3rd prior year
68525 68533 68541 68549 68557
 
34th prior year 26th prior year 18th prior year 10th prior year 2nd prior year
68526 68534 68542 68550 68558
 
33rd prior year 25th prior year 17th prior year 9th prior year 1st prior year
68527 68535 68543 68551 68559
 
  Current year
  68560
                             

Certification
             
I, , certify that the information given on this form and in any attached documents
  First and last name (print) is correct and complete.
 
   
Signature of payer   Position or office   Date (mm|dd|yyyy)