Canada Revenue Agency |
加拿大税务局 | 加拿大税务局 | |||||||||||||||||||||||
个人所得税和福利申报的电子申报信息 | |||||||||||||||||||||||||
纳税年份: | 2023 | ||||||||||||||||||||||||
The information on this form relates to the tax year shown in the top right corner. Before you fill out this form, read the information and instructions section below. Fill out this form only if you want to authorize your electronic filer to create a pre-authorized debit agreement for you with the CRA, to schedule your Individual Income Tax payment on filing for the current tax year only. The individual identified in Part A (or the individual's legal representative) must sign Part B. Your electronic filer must fill out Part C. Give the signed original of this form to your electronic filer and keep a copy for yourself. |
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Part A – Identification and address as shown on your tax return | |||||||||||||||||||||||||
名字 | 姓 | 社会保险号码 | |||||||||||||||||||||||
Mailing address: Apt number – Street number and Street name | 邮箱 | RR | 城市 | 省/区 | 邮政编码 | ||||||||||||||||||||
Part B – Pre-authorized debit agreement | |||||||||||||||||||||||||
Do you want to pre-authorize the Canada Revenue Agency (CRA) to withdraw a specified amount from your bank account? If yes, fill in the information below: |
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I hereby authorize the electronic filer identified in Part C below to create this personal pre-authorized debit on my behalf. I authorize the CRA to automatically withdraw the funds from my bank account as shown in the agreement details below. I also acknowledge that I have read and understood the information about pre-authorized debits below. |
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Signature (individual identified in Part A or legal representative) | Name and title of legal representative | 日期 | |||||||||||||||||||||||
One-time payment for your Income Tax and Benefit Return, to be withdrawn on | for the amount of | ||||||||||||||||||||||||
日期 | |||||||||||||||||||||||||
Branch number | Institution number | Account number | |||||||||||||||||||||||
Part C – Electronic filer identification | |||||||||||||||||||||||||
By signing Part B above, I declare that the following person or firm is creating a personal pre-authorized debit agreement for the person named in Part A. | |||||||||||||||||||||||||
Name of person or firm: | Electronic filer number: | ||||||||||||||||||||||||
Privacy Act, personal information bank number CRA PPU 005 | |||||||||||||||||||||||||
Information and instructions | |||||||||||||||||||||||||
Part B – Pre-authorized debit agreement | Recourse rights | ||||||||||||||||||||||||
Pre-authorized debit (PAD) is an online payment option. Through this option, you agree to authorize the CRA to withdraw a pre-determined amount from your bank account to pay tax on a specific date. Cancelling or modifying your PAD If you would like to cancel or make changes to your PAD agreement, go to canada.ca/my-cra-account and select "CRA Sign in/Register". Any changes made will require five business days to take effect. You can also submit your request to the CRA by fax at 204-983-0924 or mail it to the following address: |
You have certain recourse rights if any debit does not comply with this agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. For more information on your recourse rights, contact your financial institution or visit payments.ca. Account authorization You guarantee that you have full authority for completing a pre-authorized debit from your bank account. |
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PAD Unit Revenue Processing Section Winnipeg Tax Centre 66 Stapon Road Winnipeg MB R3C 3M2 |
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Please note that changes submitted to the CRA by fax or mail may take up to 30 days to take effect. If you do not inform the CRA of such changes on time, you may be subject to a fee if the financial institution is unable to process a debit according to your agreement. |
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