| Box |
Line Description |
Federal Slip |
|
Notes: |
|
|
Name of payer (issuer) of plan |
|
| 16 |
Annuity payments |
16 |
|
Record due to spouse's death? |
|
| 18 |
Refund of premiums |
18 |
| 20 |
Refund of unused contributions |
20 |
| 22 |
Withdrawal and commutation payments |
22 |
| 25 |
LLP withdrawal |
25 |
| 26 |
Amounts deemed received on deregistration |
26 |
| 27 |
HBP withdrawal |
27 |
| 28 |
Other income or deductions |
28 |
| 30 |
Income tax deducted |
30 |
| 34 |
Amounts deemed received on death |
34 |
| 35 |
Transfers on breakdown of marriage or common-law partner |
35 |
| 37 |
Advanced Life Deferred Annuity purchase |
37 |
| 24 |
Contributor: spouse or common-law partner |
Yes No |
| 14 |
Contract number |
14 |