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Flag  Canada Revenue
Agency
Agence du revenu
du Canada
EMPLOYEE AND PARTNER GST/HST REBATE APPLICATION  
You do not qualify for this rebate if your employer is a listed financial institution (for example, a person that was, at any time during the year, a bank, an
investment dealer, a trust company, an insurance company, a credit union, or a corporation whose principal business is lending money).
For details on how to complete this form, see Guide T4044, Employment Expenses (for employees) or Guide RC4091, GST/HST Rebate for Partners
(for members of a partnership). This form applies to 2023 and later tax years.
 
Area A – Identification (to be completed by claimant)
Last name First name and initial(s)
   
Tax year of claim (one year per claim) Social insurance number
  2023  
Name of employer or partnership (must be a GST/HST registrant) Business number of employer or partnership
  R T
Area B – Rebate calculation (to be completed by claimant)
GST rebate for eligible expenses on which you paid the GST    
  Eligible expenses, other than capital cost allowance (CCA), on which you paid the GST (total of column 3A    
  of Chart 1 on page 2 of this form)  1
  Eligible CCA on motor vehicles, musical instruments, and aircraft for which you paid the GST    
  (from column 3A of Chart 2 on page 3 of this form) +  2
  Total eligible expenses for the GST rebate (line 1 plus line 2) 64850 =  3
  Eligible GST – multiply line 3 by 5/105  4
HST rebate for eligible expenses on which you paid the HST 3B – 13% HST 3C – 14% HST 3D – 15% HST  
  Eligible expenses, other than CCA, on which you paid the HST (totals        
  of each of columns 3B, 3C, and 3D of Chart 1 on page 2 of this form)  5
  Eligible CCA on motor vehicles, musical instruments, and        
  aircraft for which you paid the HST (3B, 3C, and 3D of Chart 2 +        6
  on page 3 of this form)  
           
  Total (add lines 5 and 6 in each of columns 3B, 3C, and 3D) =  7
  Total eligible expenses for the HST rebate (add the totals
of column 3B, 3C, and 3D together from line 7)
64857    8
     
  Multiply Column 3B line 7 by 13/113  9
     
  Multiply Column 3C line 7 by 14/114  10
     
  Multiply Column 3D line 7 by 15/115  11
Total (add lines 9, 10, and 11).    
For more information to complete this section, see Guide T4044 or Guide RC4091.  12
Total expenses eligible for the HST rebate (from line 4 in Chart 3 on page 3). 64860    13
Rebate for property and services brought into a participating province.    
Enter the result from line 11 in Chart 3 on page 3 of this form.  14
Employee and partner GST/HST rebate (add lines 4, 12, and 14).    
Enter the result on line 15, and enter that amount on line 45700 of your income tax return.  15
Area C – Declaration by claimant's employer or partnership – An authorized officer of your employer or partnership must complete this area only if you
  are claiming a rebate for any expenses included on lines 4, 12, or 14 in Area B (above) for which you were paid an unreasonable allowance.
I certify that for the tax year stated above, the claimant was paid the following allowance(s), which at the time it was paid, I did not consider to be reasonable for
the purposes of subparagraphs 6(1)(b)(v), (vi), (vii), or (vii.1) of the Income Tax Act. I will not include an amount equal to this allowance when determining my
input tax credit or rebate.
  Reason for allowance(s)
Amount received $   (list activities)
Name of employer or partnership
   
Signature of employer Position of Year Month Day
or authorized officer authorized officer
Area D – Certification (to be completed by claimant)
I certify that the information in this document is, to the best of my knowledge, true, correct, and complete and that I am eligible for the employee and partner
GST/HST rebate for the tax year stated in Area A.
   
Signature Year Month Day
 
 
GST370 E (23) Vous pouvez obtenir ce formulaire en français à www.arc.gc.ca ou au 1-800-959-3376.