Person 1
Firstname :
Lastname :
Date of birth :	YYYY-MM-DD
Social Insurance Number :
Email :
Phone number (daytime) :
Phone number (nighttime) :
Civil status :	--- Civil Status --- Single Common law (or separated for less than 90 days) Married (or separated for less than 90 days) Widowed Separated Divorced
Postal address
Appartment :
Civic number :
Street :
Line 2 :
City :
Province :	--- Province --- AB - Alberta BC - British-Columbia PE - Prince-Edward-Island MB - Manitoba NS - Nova-Scotia ON - Ontario QC - Quebec SK - Saskatchewan NL - Newfoundland-and-Labrador NU - Nunavut NT - North-West Territories YT - Yukon
Postal code :
Person 2 (if spplicable)
Firstname :
Lastname :
Date of birth :	AAAA-MM-JJ
Social Insurance Number :
Email :
Phone number (daytime) :
Phone number (nighttime) :
Dependant child #1 (if spplicable)
Firstname :
Lastname :
Date of birth :	AAAA-MM-JJ
Social Insurance Number :
Dependant child #2 (if spplicable)
Firstname :
Lastname :
Date of birth :	AAAA-MM-JJ
Social Insurance Number :
Dependant child #3 (if spplicable)
Firstname :
Lastname :
Date of birth :	AAAA-MM-JJ
Social Insurance Number :
Dependant child #4 (if spplicable)
Firstname :
Lastname :
Date of birth :	AAAA-MM-JJ
Social Insurance Number :
New client of Napoli-Bertrand ?
Are you a new client client ?	--- New Client --- Y - Yes N - No
Did you include a copy of your last year notices from both federal and provincial government ?	--- Last Year Notices --- Y - Yes N - No
Did you include a copy of your last year income taxes reports ?	--- Last Year Taxes Reports --- Y - Yes N - No
Moved ?
Did you move this year ?	--- Moved --- Y - Yes N - No
Move date :	YYYY-MM-DD
Previous address (cwifsi applicable)
Appartment :
Civic Number :
Street :
Line 2 :
City :
Province :	--- Province --- AB - Alberta BC - British-Columbia PE - Prince-Edward-Island MB - Manitoba NS - Nova-Scotia ON - Ontario QC - Quebec SK - Saskatchewan NL - Newfoundland-and-Labrador NU - Nunavut NT - North-West Territories YT - Yukon
Postal code :
Phone number :
New address (if applicable)
Appartment :
Civic number :
Street :
Line 2 :
City :
Province :	--- Province --- AB - Alberta BC - British-Columbia PE - Prince-Edward-Island MB - Manitoba NS - Nova-Scotia ON - Ontario QC - Quebec SK - Saskatchewan NL - Newfoundland-and-Labrador NU - Nunavut NT - North-West Territories YT - Yukon
Postal code :
Phone number :
Civil status change (if applicable)
Has your civil status or family status change during the year (wedding, divorce, common law, child birth, etc… ) ?	--- Civil status change --- Y - Yes N - No
Date of the change :	YYYY-MM-DD
Change explanation :
Did you live alone all year?	--- Lives alone --- Y - Yes N - No
Medical Insurance
Were you covered by a private medical insurance ?	--- Private medical insurance --- Y - Yes N - No
Were your spouse covered by a private medical insurance ? Note : Many secondary private insurance plans don't cover medications, please validate.	--- Spouse private medical insurance --- Y - Yes N - No
If you or your spouse started being covered by a private medical insurance during 2023, please provide a copy of the confirmation letter provided by the insurer. On which date did the cover start ?	YYYY-MM-DD
Properties / Stocks
Did you sell assets (real estate, primary or secondary property, etc.) ?	--- Property sale --- Y - Yes N - No
If you have sold your primary residence, please provide us with a copy of your purchase and sale contracts. The same informations are required in the case of the sale of a secondary property (you or your spouse). In the case of your primary property, there are no fiscal deductions. The ministry of revenu wants to be informed about it.
Did you sell assets (shares, obligations, etc.) ?	--- Shares sale --- Y - Yes N - No
Note : In the case of shares, brokers usually provide a statement of sales or summary for the fiscal year. The purchase price of the stock rarely appear, please make sure to provide us with this information.
Shares sale value :	$
Shares purchase price :	$
Date of purchase :	YYYY-MM-DD
Date of sale :	YYYY-MM-DD
Sale fees :	$
Review
Do you have all your statements and income taxes receipts ?	--- All receipts --- Y - Yes N - No
Income : T4, Employment statement, Income insurance, Parental insurance, Retirement income, PSV, RRQ, interests T5-Dividends, Mutual Funds, Work accidents indemnities, RRSP withdrawal Deductions : RRSP, Union or Professional asociations Self Employed Revenues and expenses (PROVIDE your documents AS SOON AS POSSIBLE) School fees (must be downloaded by your child on the school web site) RL-31 from your landlord if your rented an appartment in 2023 (mandatory to receive the solidarity credit)
Did you think about all your medical expenses ?	--- Medical expenses --- Y - Yes N - No
Medications, medical insurance cost, glasses, dentist, chiropractor, psychologist, physiotherapist. Note that massage therapy are not deductible. NOTE : Your pharmacist can provide a detailed statement for a minimal fee. If yes, please provide us with teh report and all invoices.
Did you provide a room for a parent during the year ?	--- Parent room --- Y - Yes N - No
Did you benefit from the income taxes credit for house care ?	--- House care --- Y - Yes N - No
Did you send any provisional account payments; provide the required information ?	--- Provisional account payments --- Y - Yes N - No
Federal amount :	$
Provincial amount :	$
First property purchase
Did you acquire your first property (Income taxes credit opportunity) ?	--- First house purchase --- Y - Yes N - No
Date of purchase :	YYYY-MM-DD
Provide us if applicable the amount for the notary, the initial cash down and the "welcome tax" amount.
Aboce this, did you use the RAP program to purchase your property ?	--- RAP Program --- Y - Yes N - No
If yes, please provide us the RRSP statement to refund according to the federal statement
Other questions
Did you own, during the year, foreign assets of value of more than 100 000 dollars CAD ?	--- Foreign assets --- Y - Yes N - No
If yes, please describe and indicate the value :
Are-you subscribe to the direct deposit with Revenu Quebec and Canada Revenue Agency ?	--- Direct deposit --- Y - Yes N - No
If not, can you provide us with a void cheque for the Solidarity Credit
Comments and general notes
Comments :