PROTECTED B
(when completed)
REGISTRATION OF FAMILY SUPPORT PAYMENTS
Use this form to register your court order or written agreement if you meet any of the conditions outlined below:
1) Your order or agreement was made after April 1997 and it specifies support payments for a spouse or common-law partner.
2) 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:
앫
you have filed Form T1157, Election for Child Support Payments; or
앫
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 STN 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 STN Main
Shawinigan QC G9N 7V9
Winnipeg Tax Centre
PO Box 14001 STN Main
Winnipeg MB R3C 3M3
Surrey Tax Centre
9755 King George Boulevard
Surrey BC V3T 5E6
For information about the tax rules that apply, see Guide P102, Support Payments.
Personal information (please print)
Name of recipient
Telephone number
–
Name of payer
Social insurance number
–
Telephone number
–
Social insurance number
–
Information about your new or changed court order or written agreement
Year
Month Day
Year
Month Day
Year
Month Day
Year
Month Day
Enter the starting date of the payments for child support . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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 or
provincial/territorial simplified tables amounts?) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Privacy Act, Personal Information Bank number CRA PPU 005
T1158 (10)
Yes
1
No
2