*** Transcriber's Note::Please set your voice synthesizer to read most punctuation. When you encounter the caret sign at the end of a line, please enter the applicable information, if necessary. *** Canada Revenue Agency Protected B when completed RC66 E (26) (Page 1 of 6) Canada Child Benefit Application includes federal, provincial, and territorial programs Find out if this form is for you Fill out this form to apply for the Canada child benefit (CCB). The information you provide on this application will also be used to determine your eligibility for the Canada Groceries and Essentials Benefit (formerly the GST/HST credit) and related federal, provincial, or territorial programs the Canada Revenue Agency (CRA) administers. You can also use this form if you started a shared-custody situation for one or more children. Before submitting this form, refer to the list of information on page 5 that must be included with the application. If all of the required information is not included with your application, your application may be denied or delayed. Do not fill out this form if you already applied using My Account on the CRA website or when you registered the birth of your newborn with your province or territory (except Nunavut). Who can fill out this form Only the person who is primarily responsible for the care and upbringing of the child can apply by filling out this form (refer to "Primarily responsible for the care and upbringing of the child" on page 3). For CCB purposes, when a child resides with a female parent in the home, the female parent is usually considered to be primarily responsible for the child. This is referred to as the female presumption, and is a legislative requirement under the Income Tax Act. However, if the child's other parent is primarily responsible, they can apply. They must attach a signed letter from the female parent that states that the other parent with whom she resides is primarily responsible for all the children in the household. If the child lives with same-sex parents, only one parent should apply for all the children in the home. No matter which parent receives the CCB, the amount will be the same. For more information For more information on the CCB, including eligibility requirements, go to canada.ca/cra-benefits, refer to Booklet T4114, Canada Child Benefit, or call 1-800-387-1193. If you reside in Yukon, North-West Territories, or Nunavut, call 1-866-426-1527. From outside Canada or the United States, call 1-613- 940-8495. The CRA accepts collect calls by automated response. Step 1 - Your information Social insurance number (SIN) (enter 9 digit number): ^ If you do not have a SIN, refer to Booklet T4114, Canada Child Benefit, under "How to apply." If you are not eligible for a SIN, enter your temporary tax number (TTN). First name: ^ Last name: ^ Date of birth (Year/Month/Day): ^ Your language of correspondence: English or Fran ais ^ Telephone numbers: Home (including area code): ^ Work (including area code): ^ Extension: ^ Cellular (including area code): ^ Step 2 - Your address Mailing address Apartment Number - Street Number, Street name, Post Office Box, Rural Route: ^ City: ^ Province or territory (or country if outside Canada): ^ Postal or ZIP code: ^ Have you moved from a different province or territory within the last 12 months? Yes or No ^ If yes, enter the previous province or territory and the date you moved: ^ Date: (Year/Month/Day) ^ Home address Same as mailing address ^ Apartment Number - Street Number, Street name, Rural Route: ^ City:^ Province or territory (or country if outside Canada): ^ Postal or ZIP code: ^ RC66 E (26) (Page 2 of 6) Step 3 - Your marital status Select the box that applies to your current status (select only one box): Married means that you have a spouse. This term only applies to a person you are legally married to. ^ Living common-law means that you are living in a conjugal relationship with a person who is not your married spouse and at least one of the following conditions applies: ^ - This person has been living with you in a conjugal relationship for at least 12 continuous months Note In this definition, 12 continuous months includes any period you were separated for less than 90 days because of a breakdown in the relationship. - This person is the parent of your child by birth or adoption - This person has custody and control of your child (or had custody and control immediately before the child turned 19 years of age) and your child is wholly dependent on this person for support Separated means that you have been living apart from your spouse or common- law partner because of a breakdown in the relationship for a period of at least 90 days. ^ Note You are still considered to have a spouse or common-law partner if you were separated involuntarily and not because of a breakdown in your relationship. An involuntary separation could happen when one spouse or common-law partner is living away for work, school or health reasons, or is incarcerated. Once you have been separated for 90 days because of a breakdown in the relationship, the effective day of your separated status is the date you started living apart. Widowed means that you had a spouse or common-law partner who is now deceased. ^ Divorced means that you are legally divorced from your former spouse. ^ Single means that none of the other marital statuses apply to you. ^ Enter the date the selected status began (leave it blank if you have always been single): (Year/Month/Day) ^ If you selected married or living common-law, enter your spouse or common-law partner's information: Social insurance number (SIN) (enter 9 digit number): ^ If your spouse or common-law partner does not have a SIN, refer to Booklet T4114, Canada Child Benefit, under "How to apply." If your spouse or common- law partner is not eligible for a SIN, enter their TTN. First name: ^ Last name: ^ Date of birth (Year/Month/Day):^ If your spouse or common-law partner's address is different from yours, enter it here; otherwise, their address will be updated to match the address indicated in Step 2. ^ Your spouse or common-law partner is a non-resident of Canada ^ Step 4 - Your citizenship status You become a Canadian citizen when you are born in Canada or are granted Canadian citizenship by Immigration, Refugees and Citizenship Canada. Have you been a Canadian citizen for the last 12 months? Yes or No ^ Has your spouse or common-law partner (if you have one) been a Canadian citizen for the last 12 months? Yes or No ^ If you answered no to either of these questions, you have to fill out Form RC66SCH, Status in Canada and Income Information. RC66 E (26) (Page 3 of 6) Step 5 - Newcomer or returning resident of Canada Within the last two years, did you become a newcomer to Canada or return after an absence of at least six months? Yes or No ^ Within the last two years, did your spouse or common-law partner (if you have one) become a newcomer to Canada or return after an absence of at least six months? Yes or No ^ If you answered yes to either of these questions, you have to fill out Form RC66SCH, Status in Canada and Income Information. Step 6 - Information about the child(ren) You may need to provide supporting documents for the child or children for whom you are completing this form. If the CRA has not paid benefits for the child(ren) on this application, you must provide proof of birth. Refer to "What to attach to this form" on page 5 for a list of acceptable documents. Primarily responsible for the care and upbringing of the child Being primarily responsible for the care and upbringing of the child means that you are responsible for such things as supervising the child's daily activities and needs, making sure the child's medical needs are met, and arranging for child care, when necessary, when the child lives with you. Shared custody The CRA considers you to be in a shared-custody situation if the child lives with you 40% to 60% of the time and the rest of the time with another individual, generally at a different address. This normally happens after a separation or a divorce. For more information on shared custody, refer to Booklet T4114, Canada Child Benefit, under "If you share custody of a child." Do not give information about a child for whom you have already applied, unless the child left your care and has now returned, or the percentage of time the child is in your care has changed. Child 1 - Information First name: ^ Last name: ^ Gender: Female or Male ^ Date of birth (Year/Month/Day): ^ City of birth: ^ Province or territory of birth (or country if outside Canada): ^ You must be primarily responsible for the care and upbringing of this child when the child lives with you. Does the child live with you more than 60% of the time? Yes or No ^ If yes, enter the date the child started living with you more than 60% of the time. If the child has lived with you since birth, tick the box: (Year/Month/Day) ^ or Since birth ^ If no, select the box that represents the percentage of time the child lives with you (select only one box): 40% to 60% of the time, and the child lives the rest of the time with another individual at a different address (for example, the child lives with you one week and with the other individual one week, or with you 4 days a week and with the other individual 3 days a week) ^ If you select this box, the CRA considers you to be in a shared custody situation for this child. Enter the date the child started living with you 40% to 60% of the time: (Year/Month/Day) ^ Less than 40% of the time (for example, the child lives with you every second weekend) ^ If you select this box, the CRA does not consider you to be eligible for the child and family benefits for this child. RC66 E (26) (Page 4 of 6) Step 6 - Information about the child(ren) (continued) Child 2 Information First name: ^ Last name: ^ Gender: Female or Male ^ Date of birth (Year/Month/Day): ^ City of birth: ^ Province or territory of birth (or country if outside Canada): ^ You must be primarily responsible for the care and upbringing of this child when the child lives with you. Does the child live with you more than 60% of the time? Yes or No ^ If yes, enter the date the child started living with you more than 60% of the time. If the child has lived with you since birth, tick the box: (Year/Month/Day) ^ or Since birth ^ If no, select the box that represents the percentage of time the child lives with you (select only one box): 40% to 60% of the time, and the child lives the rest of the time with another individual at a different address (for example, the child lives with you one week and with the other individual one week, or with you 4 days a week and with the other individual 3 days a week) ^ If you select this box, the CRA considers you to be in a shared custody situation for this child. Enter the date the child started living with you between 40% to 60% of the time: (Year/Month/Day) ^ Less than 40% of the time (for example, the child lives with you every second weekend) ^ If you select this box, the CRA does not consider you to be eligible for the child and family benefits for this child. If you are applying for more than two children, you can use Form RC66-1, Additional Children. You can also attach a separate sheet of paper with the information asked above. Step 7 - Signature I certify that the information given on this form and in any attached document is correct and complete. I understand that it is a serious offence to make a false statement. Your signature ^ Date (Year/Month/Day): ^ Personal information (including the SIN) is collected and used to administer or enforce the Income Tax Act and related programs and activities including administering tax, benefits, audit, compliance, and collection. The information collected may be disclosed to other federal, provincial, territorial, aboriginal, or foreign government institutions to the extent authorized by law. Failure to provide this information may result in paying interest or penalties, or in other actions. Under the Privacy Act, individuals have a right of protection, access to and correction of their personal information, and to file a complaint with the Privacy Commissioner of Canada regarding the handling of their personal information. Refer to Personal Information Bank CRA PPU 063 on Info Source at canada.ca/cra-info- source. RC66 E (26) (Page 5 of 6) What to attach to this form You must attach documents to your application if any of the situations below apply to you. Your application may be denied or delayed if you do not provide all of the required information. The CRA may ask you for copies of certain documents at a later date. To get the CRA's forms and publications, go to canada.ca/cra-forms- publications or call 1-800-387-1193. If you are in the following situation: The CRA has not paid benefits to anyone for the child or children for whom you are completing this form You need to attach the following document(s) to your application: Proof of birth for the child (refer to the examples of acceptable documents below) If you are in the following situation: You answered "no" to either of these questions in Step 4: - Have you been a Canadian citizen for the last 12 months? - Has your spouse or common-law partner (if you have one) been a Canadian citizen for the last 12 months? You need to attach the following document(s) to your application: Form RC66SCH, Status in Canada and Income Information If you are in the following situation: You answered "yes" to either of these questions in Step 5: - Within the last two years, did you become a newcomer to Canada or return after an absence of at least six months? - Within the last two years, did your spouse or common-law partner (if you have one) become a newcomer to Canada or return after an absence of at least six months? You need to attach the following document(s) to your application: Form RC66SCH, Status in Canada and Income Information If you are in the following situation: You are applying for a period that began more than 11 months ago You need to attach the following document(s) to your application: Clear copies (including both sides of all pages) of all of the following documents for the entire period: - proof of birth for each child. Refer to the examples of acceptable documents below - proof that you resided in Canada (at least three documents). Refer to the examples of acceptable documents below - proof that you were the person who is primarily responsible for the care and upbringing of the child (at least three documents). Refer to the examples of acceptable documents below - proof of citizenship or immigration status in Canada for you and your spouse or common-law partner (if you have one) If you are in the following situation: You are applying for more than two children You need to attach the following document(s) to your application: Form RC66-1, Additional Children, or attach a separate sheet of paper with the information requested in Step 6 Examples of acceptable documents If your documents are in a language other than English or French, you have to provide a copy of the original documents written in the foreign language with an acceptable English or French translation. For more information, go to canada.ca/child-benefits-supporting-documents. As proof of birth, send us a copy of any of the following documents that indicates the child's family name, given name, and date of birth: - birth certificate - certified copy of birth registration - hospital record of birth, or the record of the attending physician, nurse, or midwife at the birth - baptismal or cradle roll certificate or other church record - Indian status card - passport Acceptable documents issued by Immigration, Refugee and Citizenship Canada for children born outside of Canada: - Canadian citizenship certificate (front and back) - permanent resident card - confirmation of permanent residence - notice of decision issued by the Immigration and Refugee Board of Canada - temporary resident permit As proof that you resided in Canada, send us copies of at least three of the following documents that contain your full name, address, and date covering the period of your application: - mortgage papers or your property tax bill(s) - lease agreement, rent receipts, or letter from the landlord - recent utility bill(s) (gas, electricity, cable, telephone) - bank and credit card statements - insurance policies - driver's license and vehicle registration (front and back) - membership in professional, social, or recreational organizations RC66 E (26) (Page 6 of 6) Examples of acceptable documents (continued) As proof that you are the person who is primarily responsible for the care and upbringing of the child when they live with you, send us copies of three of the following documents for the period of your application: - a letter from the daycare or school authorities showing the child's home address and contact information on file - a signed and certified copy of the child's school registration or enrolment document, or an information or emergency contact sheet - a letter from the school board or appropriate educational authority confirming that you have a home school arrangement and showing the child's home address and contact information on file - a copy of the child's report card showing the child's home address and contact information on file - a registration form or a receipt for an activity or club the child was enrolled in for the period you indicated - a complete and signed court order, decree, or separation agreement; the document must explain the type of custody arrangement you have (for example, shared custody) and clearly show the living arrangements for the child - a letter from a person in a position of authority stating that they have personal knowledge that the child lived with you for the period you indicated - any other document showing that the child lived with you for the period you indicated For a complete list of all supporting documents, go to canada.ca/child- benefits-supporting-documents. What to do now - Make sure all steps of this form are filled out. - You must include all applicable information listed in the "What to attach to this form" section on the previous page. - Make a copy of your form and related documents (if applicable) for your records. - Send your application to the tax centre that serves your area. Use the chart below to find out the address: If your province or territory of residence is: Alberta, British Columbia, Manitoba, Northwest Territories, Nunavut, Saskatchewan, or Yukon Send your application to the following address: Winnipeg Tax Centre Post Office Box 14005, Station Main Winnipeg MB R3C 0E3 If your province or territory of residence is: New Brunswick, Newfoundland and Labrador, Nova Scotia, Ontario, or Prince Edward Island Send your application to the following address: Sudbury Tax Centre Post Office Box 20000, Station A Sudbury ON P3A 5C1 If your province or territory of residence is: Qu bec Send your application to the following address: Jonqui re Tax Centre 2251 Ren -L vesque Boulevard Jonqui re QC G7S 5J2 After you apply Unless you tell the CRA otherwise, the information you give on this form will be used for all benefit programs, including federal, provincial, and territorial programs. If you do not meet the eligibility criteria for the CCB or any other program, you will need to re-apply once you meet all of the conditions. Your application may be denied or delayed if you do not provide all of the required information. Once the CRA has processed your application, a CCB notice will be sent to you. The notice will show if you are eligible, how much you will get (if applicable), and what information was used to calculate the amount. The CRA's goal is to issue your notice or payment, if applicable, within 11 weeks of receiving your completed paper application. The CRA may also review your situation at a later date to confirm that your information has not changed. Getting your payments You need to do your taxes on time every year so that we can calculate your payments, even if you had no income in the year. If you don't file your tax return every year, your payments will stop. If you have a spouse or common- law partner, they also need to do their taxes every year. Make sure your personal information is up to date with the CRA, as this could also affect your payments. Direct deposit Direct deposit is a fast, convenient, and secure way to receive your CRA payments directly in your account at a financial institution in Canada. For more information, go to canada.ca/cra-direct-deposit or contact your financial institution. If your spouse or common-law partner is a non-resident If your spouse or common-law partner is a non-resident of Canada, the CRA needs their income information for each year (or part of the year) they were a non-resident of Canada to determine your child and family benefits and credits. You can provide this information by filling out Form CTB9, Income of Non-Resident Spouse or Common-Law Partner. Mail it to the tax centre that serves your area or submit it electronically using My account at canada.ca/cra-sign-in-services. You can also call 1-800-387-1193 to provide the information.