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    PERSONAL INCOME TAX QUESTIONNAIRE FORCANADIAN INDIVIDUAL TAX RETURNS

    2013 TAXATION YEAR

    2013 TAX QUESTIONNAIRE INSTRUCTIONSEnclosed is your 2013 income tax return questionnaire which will assist you in assembling data for thepreparation of your 2013 individual Canadian income tax return(s). Your careful attention to the completionof the questionnaire will enable us to prepare your return(s) efficiently and accurately. This taxquestionnaire is not designed to replace the personal contact that we believe is necessary to provide youwith the complete service we desire to render. Please do not hesitate to contact us if you have anyquestions.

    1. Table of contents - Review the contents to ensure you only answer sections of the questionnaireapplicable to your particular circumstances. If the answer to a question is no, skip the related section inthe questionnaire.

    If I&A prepared prior tax returns for you - Some of the information requested in this questionnaire

    may already be in our possession. If this is the case, please complete the taxpayer information page, andthe income and deduction summaries. Please provide us with a copy of your prior year Notice of

    Assessment, if applicable.

    If I&A did not prepare your returns in prior years - Complete all relevant sections and provide a copy ofyour prior year Canadian tax return(s) and Notice of Assessment, if applicable.

    Slips/Receipts - If you are submitting your information electronically, please scan and email, or fax yourslips and receipts to us. We do not need to receive original receipts.

    Due Date - For timely completion of your tax return(s), complete and return this questionnaire to us byAp ri l 15, 2014.

    2013 RRSP Contribution - 2013 RRSP contributions must be made by March 3rd, 2014 in order to bedeductible for the 2013 taxation year. The amount that you can contribute to an RRSP for the 2013 taxationyear may be found on your 2012 Notice of Assessment from Canada Revenue Agency (CRA).

    PLEASE PAY CLOSE ATTENTION TO THE T1135 FORM.If you have any foreign investment/rental

    properties, foreign properties which also includes, investment in shares or bonds of U.S. or other foreign

    countries, even if the shares/bonds are held with a Canadian investment dealer, then please fill out the

    FOREIGN REPORTING T1135 sheet provided.You must fill out the T1135 form on the CRA website and it

    must be filed to the CRA no later than April 30, 2014. For more information regarding this form, please contact

    our office.

    Please take note of the various due dates for 2013 Canadian income tax returns.

    Canadian Income Tax Returns Deadline

    Deadline for filing return (no extensions are available)

    April 30, 2014

    Deadline for paying 2013 balance due to avoid interest and late-filing penalties April 30, 2014

    Deadline for filing return (self-employed) June 15, 2014

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    TABLE OF CONTENTS

    To start, simply check off the following items that are applicable to you. Then go to the pagesindicated for further information. All other sections can be disregarded.

    General Information Section Reference

    1. Taxpayer information (Applicable to All) X Yes Taxpayer Information

    2.

    Foreign Reporting (Applicable to All) X Yes Foreign Reporting

    3. Slips Summary (Applicable to All) X Yes Slips Summary

    4. Did you make any tax instalments?

    5. If you have a refund would you like it deposited directly toyour bank account?

    Yes No

    Yes No

    Tax Instalments

    Tax Instalments

    Sources of Income6. Income summary (Applicable to All) X Yes Income Summary

    7. Did you sell any property, including shares, or did youtransfer property by way of a gift or receive any gift?

    Yes No Capital Gains (Losses) Schedule

    8. Did you sell your principal residence during the year? Yes No Capital Gains (Losses) Schedule

    9. Did you earn rental income?

    10. Were you self employed, an active member of a partnership,or have employment expenses?

    Yes No Rental Income

    Yes No Business Income and Expenses

    Expenses and Deductions

    11. Deduction Summary (Applicable to All) X Yes Deductions Summary

    12. Did you have a Canadian RRSP or RPP? Yes No Deductions Summary

    13. Did you incur unreimbursed employee business expenses? Yes No Deductions Summary

    14. Did you or a dependent incur tuition expenses? Yes No Deductions Summary

    15. Did you incur childcare expenses? Yes No Deductions Summary

    16. Did you incur any other deductible expenses during 2013? Yes No Deductions Summary

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    TAXPAYER INFORMATION

    THIS SECTION MUST BE COMPLETED

    A) Did we prepare your return last year?

    B) Would you like to receive the "client copy"

    Yes No

    of your return(s) electronically or via paper copy? Electronically Paper Copy

    C) Taxpayer Spouse

    Name:

    Address:

    Telephonenumbers: Home

    Business

    E-mail address:

    Birth Date (mm/dd/yy):Citizenship:

    SIN (Social Insurance Number):

    D) Did your spouse have any income in 2013? Yes No

    If we are preparing his or her return please provide details of his or her income in the organizer.

    If we are not preparing his or her return, please provide us with his or her net income for 2013.

    $

    E) Please indicate your marital status at December 31, 2013:

    Legally married Widowed Divorced Separated Single Living common-law1

    Ifchangedfrompreviousyear,pleaseindicatedate:

    F) If a Canadian citizen, do you authorize the CRA to provide yourname, address, date of birth, and citizenship to Elections Canada toupdate the National Register of Electors? Yes No N/A

    G) Province of residence at December 31, 2013

    H) DependentsName Birth Date SIN Net income

    1Common-law partner: person of the opposite sex or same-sex who was living with you in 2013 in a common-law partner relationship

    and:

    is the natural or adoptive parent (legal or otherwise) of your child; or

    has been living with you at least 12 continuous months (including any period of separation of less than 90 days)

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    FOREIGN REPORTING

    THIS SECTION MUST BE COMPLETED

    Foreign Property

    At any time in 2013, did you own or acquire non-Canadian investment property2 with Yes Noa total cost in excess of $100,000?

    If you check "yes" to this question, please also complete the worksheet named"Foreign Property-T1135 Reporting".

    If you wish to review or complete the form yourself, please go to:http://www.cra-arc.gc.ca/E/pbg/tf/t1135/README.html

    FOREIGN PROPERTY T1135 REPORTING

    IMPORTANT: There are substantial penalties for failing to complete and file FormT1135 by the due date (Apri l 30 / June 15, 2014).

    Please indicate with an X to describe the cost of each type of property you or spouse own.

    Over $1million

    Over$700,000

    Over$500,000

    Over$300,000

    Over$100,000

    Lessthan

    $100,000

    Location ofinvestment

    Funds held outside Canada

    Shares of non-resident corporations

    Indebtedness owned by non-resident

    Interest in non-resident trusts

    Real property outside Canada *

    Other property outside Canada

    2Foreign investment property includes foreign bank accounts, foreign tangible property (such as a rental

    property),sharesofnonCanadiancorporations,interestsinnonCanadiantrustsorothernonCanadianentities.Excluded

    itemsincludepropertyusedinanactivebusiness,personaluseproperty(suchasavacationhome),interestsinforeign

    truststhatprovideretirementbenefits,assetsheldwithinaRRSP,aRRIForaRPPandforeigninvestmentsheldinmutual

    fundsregisteredinCanada.

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    SLIPS SUMMARY

    Please indicate how many of each type of slip, statement, or summary you are sending us.

    NumberIncluded

    NumberOutstanding Slip Name

    T3 - statement of trust income

    T4 - statement of remuneration paid

    T4A - statement of pension, retirement, annuity and other income

    T4A(OAS) - statement of old age security benefits

    T4A(P) - statement of CPP/QPP benefits

    T4E - statement of employment insurance benefits

    T4RIF - statement of RRIF income

    T4RSP - statement of RRSP income

    T4PS - statement of employee profit sharing plan

    T5 - statement of investment income

    T5013 - statement of partnership income

    T2202A - tuition, education and textbook amounts certificate

    Receipts - charitable donations

    Receipts - medical expenses

    Receipts - political donations

    Receipts - RRSP contributions

    Others

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    INCOME SUMMARY

    Please indicate what types of income you have.

    Employment IncomeSupporting Documents

    Salary, commissions, tips, etc T4, T4A, T2200.Pension Income

    Old Age Security (OAS), CanadaPension Plan (CPP)

    T4(OAS), T4(P)

    RRSP, RRIF T4RSP, T4RIFDividends, interest, estate andtrust

    T5, T3, T5008

    Professional or Business Income See Business Income PagePartnership Income T5013Rental Income See Rental Income Page

    Capital Gains See Capital Gains (Losses) PageOther Income

    Employment Insurance Benefits(EI)

    T4E

    Retiring Allowance T4AHome Buyers Plan

    Did you participate bywithdrawing from your RRSP?

    See RRSP Page

    CAPITAL GAINS (LOSSES)SCHEDULE

    Dispositions or g ifts o f capital property (shares, debentures, options, real estate,

    jewellery, works of art, rare stamps, coins) Report all amounts in original currency.

    For shares and bonds, submit your brokers annual transaction summaries.

    For other capital property, submit the sales and acquisition contracts.

    If you bought the property at different times, please provide separately all detailed informationrelated to the purchase. Cost for Canadian purposes must be calculated using the weighted-average method.

    Description

    Owner-ship %

    USD /CAD

    Date of salemm/dd/yy

    Numberof shares

    / unitssold

    Grosssellingprice

    Commiss-ions or

    sales fees

    Acquisi tiondate

    mm/dd/yy

    Adjustedcostbase

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    1st Property 2n Property 3r PropertyPartner(s) share (%) Partner(s) share (%)

    Partner(s) share (%)

    Partners / co-owners name Partners / co-owners name

    Partners / co-owners name

    RENTAL INCOME

    (If the following summary is completed, you do not need to submit any actual receipts.)

    1st Property

    2nd Property

    3rd Property

    Address Address Address

    City, province, postal code City, province, postal code City, province, postal code

    Is this the final year ofrental?

    Yes No

    Is this the final year ofrental?

    Yes No

    Is this the final year ofrental?

    Yes No

    Details of partners/co-owners:

    If financial statements are available for the rental property, please attach a copy per property. If not, pleasecomplete the following table for each property.

    1st Property

    2nd Property

    3rd Property

    Rental income (gross)Expenses

    Advertising

    InsuranceMortgage Interest

    Maintenance and repairsManagement and administration feesOffice expensesLegal, accounting, other professional feesProperty taxes

    Utilities (electricity, heating)Portion applicable to personal use

    % % %

    During 2013, did you carry out any major repairs or acquire any furnish ings? Specify the nature,date, and amount fo r each expenditure

    Descript ion and date

    Cost

    1st Property

    Cost

    2nd Property

    Cost

    3rd Property

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    BUSINESS OR PROFESSIONAL INCOME AND EXPENSES

    (If the following summary is completed, you do not need to submit any actual receipts.)

    Name of BusinessBusiness Year Period (mm/dd/yy):From:_____To:

    Address TypeofBusiness

    ________ First year? _____Last year?Federal Business Number

    Income (Attach the financial statements, if any; otherwise, please complete the following)Income (excluding GST/HST)

    Expenses

    Advertising

    Automobile expenses (complete next section)

    Bad debtsBusiness taxes, fees, licenses and membership duesConventions (see next page)Delivery, transportation, and messenger

    Depreciation (see next pages)Home office expenses (complete next section)

    InsuranceInterestMaintenance and repairs (except motor vehicles)Management and administration feesMeals and entertainment (100%)

    Office expenses (stationary, postage, supplies, etc.)Professional fees (accountant, lawyer, etc.)

    Rent (except for home office)Salaries and taxable benefitsTelephoneTravel (except for automobile expenses)Training

    Automobi le Expenses

    Make and model of automobile:Date of purchaseCost

    Number of km/miles driven in 2013

    Number of km/miles driven for business purposes in 2013

    Undepreciated balance at beginning of the yearAutomobile expenses:

    Oil and gasRepairs and maintenanceInsurance

    Interest on car loanRegistration and license

    Lease paymentsParking

    Total expensesAmount reimbursed by your employer (if applicable)

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    Did you change your automobile during the year? If yes:

    Previous automob ileMake and model:Date of purchase

    Cost before GST/HST

    Date of sale

    Proceeds of dispositionNew automobile

    Make and model:Date of purchaseCost before GST/HST

    GST/HST

    Home Office Expenses

    Total area of business-related spaceTotal area of home

    Home office expenses:

    Heating

    Electricity

    Home insuranceRepairs and maintenance

    Rent or mortgage interestProperty taxesMunicipal and school taxesOther expenses

    Total expenses

    Total cost of the house (including notary fees, commission, GST/HST,and property taxes

    Conventions

    Name of organization and location of conventionExpenses food,lodging, fees

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    DEDUCTIONS SUMMARY

    Please indicate what types of deductions you have and what kind of documentation you areproviding.

    RRSP contributions

    Union / professional dues

    Child care expenses (please include name,address, and tax identification number ofcaregiver)

    Public transit passes

    Support payments paid

    Interest paid on investments

    Safety deposit box rental

    Deductible employment expense See Business Income and Expenses page

    Tuition fees / education amount

    T2202A

    Interest paid on student loans

    Letter from Student Loan Service Bureau

    Medical / attendant care expenses See Donations and Medical Expenses page

    Charitable donations See Donations and Medical Expenses page

    Political / municipal contributions

    DONATIONS AND MEDICAL EXPENSES

    Donation Summary

    Charity nameAmount youcontributed

    CAD

    Amount yourspouse

    contributed

    CAD

    Total

    * include copies of official donation receipts from charities to attach to return

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    Medical Expense Summary 3

    Date paid Name of patient Payment made to Description Amount CAD

    Total

    * include copies of receipts to attach to return

    RRSP / RPP

    (Please enter amounts in CAD)

    Registered Retirement Savings Plans

    Did you and/or your spouse hold one or more RRSP accounts? Yes No

    Please provide a copy of your and your spouse's 2012 Notice of Assessment or Reassessment or other CRAstatement detailing your and your spouse's 2013 RRSP contribution limit, as calculated by the CRA.

    Did you have an RRSP over-contribution in the prior year? Yes No

    Ifyes,pleaseprovidetheamountanddateofcontribution:

    Did you or your spouse participate in the Home Buyers Plan and/or LifelongLearning Plan by making:

    A withdrawal from your RRSP in 2013?

    Yes No

    A withdrawal from your RRSP in a prior year?

    Yes No

    If you answered Yes to either question, please provide the following information:

    Home Buyers Plan

    Lifelong Learning PlanTaxpayer:

    Date of withdrawal from planOriginal withdrawal amount

    Prior repaymentsDesignated repayment for 2013

    Spouse:Date of withdrawal from planOriginal withdrawal amount

    Prior repaymentsDesignated repayment for 2013

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    TAX INSTALMENTS

    If you paid tax instalments for 2013, please complete the following schedule and provide applicable slips orstatements from the taxation authorities as well as cancelled cheques or bank statements if available.

    2013 Instalments

    Canada

    Taxpayer

    Payment Datemm/dd/yy Amount

    Spouse

    Payment Datemm/dd/yy Amount

    Refunds

    If you want your refund directly deposited into your account, please provide us with a copy of a void chequeor your account details.

    Name of Canadian financial institution:Branchnumber:Institution number:

    Account number:

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    ADDITIONAL INFORMATION