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Flag Canada Revenue
Agency		 Agence du revenu
du Canada		  
 
Capital Gains on Gifts of Certain Capital Property  
 
 
Use this form if you donated any of the following types of properties to a registered charity or other qualified donee in 2024:
 • a share, debt obligation, or right listed on a designated stock exchange
 • a share of the capital stock of a mutual fund corporation
 • a unit of a mutual fund trust
 • a prescribed debt obligation
 • an interest in a related segregated fund trust
 • ecologically sensitive land (including a covenant, an easement or, for land in Quebec, a real servitude or, under certain
conditions, a personal servitude) where it is gifted to certain qualified donees

If there is no advantage in respect of the gift, the full amount of the capital gain realized on the gift is eligible for an inclusion
rate of zero. However, if there is an advantage, only a portion of the capital gain is eligible for the inclusion rate of zero. The
rest is subject to the inclusion rate calculated on Schedule 3, Capital Gains or Losses.
 
Complete page 2 for dispositions from January 1 to June 24, 2024 (Period 1). Complete page 3 for dispositions from June 25
to December 31, 2024 (Period 2). Report these amounts on Schedule 3, as indicated on page 2 and 3.
 
The inclusion rate of zero is extended to any capital gain realized on the exchange of shares of the capital stock of a
corporation for securities listed in the first five bullets above that are donated within 30 days of the exchange if certain
conditions are met.
 
If the exchanged property is a partnership interest (other than prescribed interests in a partnership), a special calculation is
required to determine what the capital gain will be. For Period 1 dispositions, report the amount directly on line 17399 in Part
4 of Schedule 3. For Period 2 dispositions, report the amount on line 17400 in Part 4 of Schedule 3.
 
You may donate property to a qualified donee that is at the time of the donation included in a flow-through share (FTS) class
of property. At that time, you may also have an exemption threshold in respect of the FTS class of property. If this is the case,
you may be deemed to have an additional capital gain from the disposition of another capital property subject to the inclusion
rate calculated on Schedule 3.

You or your spouse or common-law partner may be able to claim a non-refundable tax credit for these gifts.

For more information, see Guide P113, Gifts and Income Tax.
   
T1170 E (24) (Ce formulaire est disponible en français.) Page 1 of 3 Canada Logo  
Protected B when completed
 
Capital Gains on Gifts of Certain Capital Property
Period 1 – Dispositions from January 1 to June 24, 2024
 
Include this form with your return. If you need more space, attach a separate sheet of paper to your return.
 
Shares and rights that are publicly traded, other shares, segregated fund units and mutual fund units (7)
Gain eligible for		 (8)
Gain to report on		  


Number

Name of fund corporation
and class of shares
(1)
Year
acquired
(2)
Proceeds of
disposition
(3)
Adjusted cost
base
(4)
Outlays and
expenses
(5)
Gain
(column 2 minus
columns 3 and 4)
(6)
Eligible amount
of gift		 0% inclusion rate
(column 5 multiplied
by column 6 divided
by column 2)		 Schedule 3
(column 5
minus
column 7)		  
 
+ + +  
+ + +  
Total  68214 = Total  68215 = =  1
 
Include the amount from line 1 of column 8 on line 10690 in Part 3 of Schedule 3.
 
Bonds and debentures that are publicly traded, and other properties (7)
Gain eligible for		 (8)
Gain to report on		  


Face value

Maturity date
(YYYYMMDD)

Name of issuer
(1)
Year
acquired
(2)
Proceeds of
disposition
(3)
Adjusted cost
base
(4)
Outlays and
expenses
(5)
Gain
(column 2 minus
columns 3 and 4)
(6)
Eligible amount
of gift		 0% inclusion rate
(column 5 multiplied
by column 6 divided
by column 2)		 Schedule 3
(column 5
minus
column 7)		  
 
+ + +  
+ + +  
Total  68216 = Total  68217 = =  2
 
Include the amount from line 2 of column 8 on line 10694 in Part 3 of Schedule 3.
 
Ecologically sensitive land (including a covenant, an easement or, for land in Quebec, a real servitude or,
under certain conditions, a personal servitude)		 (7)
Gain eligible for		 (8)
Gain to report on		  


Address or legal description of land
(1)
Year
acquired
(2)
Proceeds of
disposition
(3)
Adjusted cost
base
(4)
Outlays and
expenses
(5)
Gain
(column 2 minus
columns 3 and 4)
(6)
Eligible amount
of gift		 0% inclusion rate
(column 5 multiplied
by column 6 divided
by column 2)		 Schedule 3
(column 5
minus
column 7)		  
 
+ + +  
+ + +  
Total  68218 = Total  68219 = =  3
 
Include the amount from line 3 of column 8 on line 10692 in Part 3 of Schedule 3.
 
Add lines 68215, 68217 and 68219. Enter this amount on line 21 for period 1 in Part 4 of Schedule 3.   =  4
 
T1170 E (24) Page 2 of 3
Protected B when completed
 
Capital Gains on Gifts of Certain Capital Property
Period 2 – Dispositions from June 25 to December 31, 2024
 
Include this form with your return. If you need more space, attach a separate sheet of paper.
 
   
Shares and rights that are publicly traded, other shares, segregated fund units and mutual fund units (7)
Gain eligible for		 (8)
Gain to report on		  


Number

Name of fund corporation
and class of shares
(1)
Year
acquired
(2)
Proceeds of
disposition
(3)
Adjusted cost
base
(4)
Outlays and
expenses
(5)
Gain
(column 2 minus
columns 3 and 4)
(6)
Eligible amount
of gift		 0% inclusion rate
(column 5 multiplied
by column 6 divided
by column 2)		 Schedule 3
(column 5
minus
column 7)		  
 
+ + +  
+ + +  
Total  68220 = Total  68230 = =  1
 
Include the amount from line 1 of column 8 on line 13200 in Part 3 of Schedule 3.
 
Bonds and debentures that are publicly traded, and other properties (7)
Gain eligible for		 (8)
Gain to report on		  


Face value

Maturity date
(YYYYMMDD)

Name of issuer
(1)
Year
acquired
(2)
Proceeds of
disposition
(3)
Adjusted cost
base
(4)
Outlays and
expenses
(5)
Gain
(column 2 minus
columns 3 and 4)
(6)
Eligible amount
of gift		 0% inclusion rate
(column 5 multiplied
by column 6 divided
by column 2)		 Schedule 3
(column 5
minus
column 7)		  
 
+ + +  
+ + +  
Total  68240 = Total  68250 = =  2
 
Include the amount from line 2 of column 8 on line 15300 in Part 3 of Schedule 3.
 
Certified ecologically sensitive land (including a covenant, an easement or, for land in Quebec,
a real servitude or, under certain conditions, a personal servitude)		 (7)
Gain eligible for		 (8)
Gain to report on		  


Address or legal description of land
(1)
Year
acquired
(2)
Proceeds of
disposition
(3)
Adjusted cost
base
(4)
Outlays and
expenses
(5)
Gain
(column 2 minus
columns 3 and 4)
(6)
Eligible amount
of gift		 0% inclusion rate
(column 5 multiplied
by column 6 divided
by column 2)		 Schedule 3
(column 5
minus
column 7)		  
 
+ + +  
+ + +  
Total  68251 = Total  68252 = =  3
 
Include the amount from line 3 of column 8 on line 13800 in Part 3 of Schedule 3.
 
Add lines 68230, 68250 and 68252. Enter this amount on line 21 for period 2 in Part 4 of Schedule 3.   =  4
 
See the privacy notice on your return.
 
   
T1170 E (24)       Page 3 of 3