Agency
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Identification
Canada Revenue
STATEMENT OF REAL ESTATE RENTALS
1
Your
name
For the
YYYY MM DD
YYYY MM DD
period from:
to:
Name and address of person or firm preparing this form
Your social
insurance number
Yes
Was this the final year of your rental operation?
Partnership filer identification number
David Bacic & Associates Ltd.
601 - 938 Howe Street
Vancouver BC V6Z 1N9
No X
Tax shelter identification number
Business Number
Your percentage of ownership
100
%
Industry code
531111
Details of other co-owners and partners
Co-owner or partner's
name and address
Share of net income (loss)
$
Percentage of ownership
%
Co-owner or partner's
name and address
Share of net income (loss)
$
Percentage of ownership
%
Income
Address of property
Number of units
Enter the total of your gross rents
Other related income (for example, premiums
and leases, sharecropping)
Gross rental income (enter this amount on line 160 of your income tax and benefit return.)
Gross rents
8141
8230
8299
(a)
Expenses
Total expense
Advertising
Insurance
Interest
Maintenance and repairs
Management and administration fees
Motor vehicle expenses (not including capital cost allowance)
Office expenses
Legal, accounting, and other professional fees
Property taxes
Salaries, wages, and benefits (including employer's contributions)
Travel
Utilities
Other expenses:
Personal portion
8521
8690
8710
8960
8871
9281
8810
8860
9180
9060
9200
9220
9270
Total
9949
Deductible expenses (total expenses minus personal portion)
Net income (loss) before adjustments (line a minus line b)
Co-owners - Your share of line 9369 above
Minus: Other expenses of the co-owner
(b)
9369
<NIL>
(c)
9945
Subtotal
Plus: Recaptured capital cost allowance (co-owners - enter your share of the amount) (see Chapter 3)
9947
Subtotal
Minus: Terminal loss (co-owners - enter your share of the amount) (see Chapter 3)
9948
Subtotal
Minus: Capital cost allowance (from Area A)
Net income (loss) - If you are a sole proprietor or a co-owner, enter this amount on line 9946.
Partnerships - Your share of line d above
Plus: GST/HST rebate for partners received in the year
Minus: Other expenses of the partner
9936
Your net income (loss) (enter this amount on line 126 of your income tax and benefit return)
9946
T776 E (09)
See disclaimer on page 2
(d)
9974
9943
<NIL>
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Name of taxpayer
Social Insurance Number
Printed
2010/09/16
Capital Cost Allowance
Area A - Calculation of capital cost allowance claim
Class /
UCC - Start
Cost of
Proceeds
Adjustments
Pool
of Year
Additions
of Disp
Unadjusted
UCC
1/2
Additions
Reduced
UCC
Rate
(%)
CCA
UCC - End
of Year
Total
Area B - Details of equipment and other property additions in the year
1
2
Class / Pool
Property details
3
Total cost
4
Personal part
5
Rental part
Total equipment and other property additions in the year 9925
Area C - Details of building and leasehold interest additions in the year
1
2
3
4
Class / Pool
Property details
Total cost
Personal part
5
Rental part
Total building and leasehold interest additions in the year 9927
Area D - Details of equipment and other property dispositions in the year
1
2
3
4
Class / Pool
Property details
Proceeds of disposition
Personal part
5
Rental part
Total equipment and other property dispositions in the year 9926
Note: If you disposed of rental property in the year, see Chapter 3 in Guide T4036, Rental income, for information about your proceeds of disposition.
Area E - Details of building and leasehold interest dispositions in the year
1
2
3
Class / Pool
Property details
Proceeds of disposition
4
Personal part
5
Rental part
Total building and leasehold interest dispositions in the year 9928
Note: If you disposed of rental property in the year, see Chapter 3 in Guide T4036, Rental income, for information about your proceeds of disposition.
Area F - Details of land additions and dispositions in the year
Cost of all land additions in the year
9923
Proceeds from all land dispositions in the year
9924
Disclaimer:
NOTICE TO READER
I have compiled these statements based on information provided to me by Management. I have not performed an audit or a review
engagement in respect of these financial statements and, accordingly, I express no assurance thereon. Readers are cautioned that
these statements may not be appropriate fortheirpurposes.
David Bacic, CGA
Page 2
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