Protected B when completed Registration of Family Support Payments Use this form to register your court order or written agreement if: • your order or agreement was made after April 1997 and it specifies support payments for a spouse or common-law partner; or • your order or agreement was made before May 1997, it specifies support payments for a spouse or clearly specifies separate amounts for a spouse and for a child, and: – you have filed Form T1157, Election for Child Support Payments; or – your order or agreement was changed after April 1997 to increase or decrease the amount of child support payable. Complete a separate form for each order or agreement you are registering. Send the completed form and a copy of your order or agreement to one of the tax centres listed below: St. John's Tax Centre PO Box 12072 Station A St. John's NL A1B 3Z2 Jonquière Tax Centre 2251 René-Lévesque Boulevard Jonquière QC G7S 5J2 Sudbury Tax Centre 1050 Notre Dame Avenue Sudbury ON P3A 5C2 Summerside Tax Centre 105-275 Pope Road Summerside PE C1N 6E8 Shawinigan-Sud Tax Centre PO Box 4000 Station Main Shawinigan QC G9N 7V9 Winnipeg Tax Centre PO Box 14001 Station Main Winnipeg MB R3C 3M3 Surrey Tax Centre 9755 King George Boulevard Surrey BC V3T 5E6 For more information, see Guide P102, Support Payments. Part 1 – Personal information (please print) Name of recipient Telephone number Social insurance number Name of payer Telephone number Social insurance number Part 2 – Information about your new or changed court order or written agreement Enter the starting date of support payments for a child. Enter the starting date of support payments for a spouse or common-law partner. Enter the annual support payments to be made for a child. $ Enter the annual support payments to be made for a spouse or common-law partner. $ Enter the date support payments for a child are scheduled to end. Enter the date support payments for a spouse or common-law partner are scheduled to end. Will the amounts of these support payments be adjusted in any way while this order or agreement is in effect? (For example, will they be changed in accordance with increases in the consumer price index or increases in the federal, provincial or territorial simplified tables amounts?) Month Day Year Month Day Year Month Day Year Month Day Yes Privacy Act, Personal Information Bank number CRA PPU 005 T1158E (13) Year (Vous pouvez obtenir ce formulaire en français à www.arc.gc.ca/formulaires ou en composant le 1-800-959-7383.) 1 No 2