Free untitled - Canada

T1-2009

Schedule 4

Statement of Investment Income
State the names of the payers below and attach any information slips you received. Attach a separate sheet of paper if you need more space. Attach a copy of this schedule to your return. I ­ Taxable amount of dividends (eligible and other than eligible) from taxable Canadian corporations (see line 120 in the guide) Taxable amount of dividends other than eligible dividends (specify): 1

+ +
Add lines 1 to 3 and enter this amount on line 180 of your return. 180 = continue on next page
5000-S4 ­ 1

2 3 4

Taxable amount of eligible dividends (specify):

+ + +
Add lines 4 to 7 and enter this amount on line 120 of your return. II ­ Interest and other investment income (see line 121 in the guide) Specify: 120 =

5 6 7

+
Income from foreign sources: Enter this amount on line 121 of your return.

+
121 =

5000-S4 ­ 2

III ­ Net partnership income (loss) (see line 122 in the guide)

+
Enter this amount on line 122 of your return. IV ­ Carrying charges and interest expenses (see line 221 in the guide) Carrying charges (specify): Interest expenses (specify): Enter this amount on line 221 of your return. 221 122 =

+ =

5000-S4 ­ 3