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Canada Revenue Agency |
Agence du revenu du Canada |
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| Statement of Deferred Security Options Benefits | Tax year | ||||||||||
| Complete this form to report the security options benefits you have deferred for exercising a security option after February 27, 2000, and no later than 4 pm EST March 4, 2010, to acquire eligible securities as a result of your employment. Eligible securities are common shares of a class listed on a designated stock exchange in or outside Canada and units of mutual fund trusts. |
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| The deferred benefits must be included in your employment income in the year that you dispose of the security, become a non-resident, or die. |
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| You must file this form with your return each year that you have an outstanding balance of deferred security options benefits, whether or not you have deferred any security options benefits in the year or disposed of any securities in the year relating to a security option benefit that was previously deferred. |
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| Opening balance of deferred security options benefits | |||||||||||
| (from your previous year's notice of assessment or reassessment) | 1 | ||||||||||
| Benefits that can no longer be deferred: | |||||||||||
| before June 25th, 2024 (see note 1) | 65200 | 2 | |||||||||
| Benefits that can no longer be deferred: | |||||||||||
| after June 24th, 2024 (see note 2) | 65210 | + | 3 | ||||||||
| Total benefits that can no longer be deferred: line 2 plus line 3 | |||||||||||
| (enter this amount on line 10100 of your return) | = | ► | 4 | ||||||||
| Closing balance of deferred security options benefits: line 1 minus line 4 | 65220 | = | 5 | ||||||||
| If the amount on line 5 is more than "0," the Canada Revenue Agency will show it on your notice of assessment. | |||||||||||
| Note 1: | If you disposed of securities before June 25, 2024, include 50% of the amount from line 2 on line 24900 of your return. |
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| Note 2: | If you disposed of securities after June 24, 2024, include 33.3333% of the amount from line 3 on line 24900 of your return. |
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| You may be able to claim a deduction for donating securities that you acquired through your employer's security options plan. For more information, see "Gifts of securities acquired under a security option plan" in Guide P113, Gifts and Income Tax. |
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| See the privacy notice on your return. | |||||||||||
| T1212 E (24) | (Ce formulaire est disponible en français.) | ||||||||||