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REQUEST FOR LOSS CARRYBACK BY A TRUST
Use this form to claim a loss carryback by a trust under sections 111 and 41 of the Income Tax Act. Section 80 may reduce the amount of loss to be carried over. Complete and file one copy of this form by the filing due date of the trust's income tax return for the year in which the loss occurred. You can file this form separately or include it with the T3 return for the year of the loss. If you want to claim a loss carryforward in a future year, you have to claim the carryforward on a T3 return for a year after the year of the loss. If you apply a loss to a return for a previous year, you will not reduce any late-filing penalty that applies to the T3 return for the tax year to which you apply the loss, nor will applying the loss reduce the amount allocated to any of the beneficiaries of the trust. For more information, see lines 51 and 52 in the publication T4013, T3 Trust Guide. You can get this guide from our Web site at www.cra.gc.ca/forms.
Name of trust Trust account number

T

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Tax year of loss

Section 1 ­ Non-capital loss You can carry a non-capital loss back three tax years. Use the amounts from the T3 return for the loss year unless otherwise specified. Enter all the amounts without brackets. When you calculate the income or loss from the sources listed below, the amounts you deducted at lines 21 and 24 and certain amounts deducted at line 40 of the T3 return (except those listed in Note 1 below) will reduce the income or increase the loss from any sources to which they relate. Notes: 1) Include all deductions that are not attributable to any particular source of income. This includes refund interest repaid and legal fees paid for advice or help to object to or appeal an assessment under the Income Tax Act. 2) Add the dividend gross-up amount (from line 49 of the T3 return) to dividends included in calculating investment income or loss.
Income Loss

Taxable capital gains Capital gains deduction Pension income Investment income or loss (see Note 2 above) Business income or loss Farming income or loss (do not include restricted farm losses ­ see Area 5) Fishing income or loss Rental income or loss NISA Fund No. 2 Deemed dispositions from Form T1055 Other income Allowable business investment losses Treaty-exempt income (included on line 54 of the T3 return) Net capital losses of other years (from line 52 of the T3 return) Subtotals Other deductions (see Note 1 above) Subtotal (line 1 minus line 3; if negative, enter "0") Subtotal (line 2 minus line 4; if negative, enter "0") Amount from line 5 or line 14, whichever is less Total non-capital loss for the year (line 5 minus line 6; if negative, enter "0") Subtract: Non-capital loss to be applied to (enter tax year) Non-capital loss to be applied to (enter tax year) Non-capital loss to be applied to (enter tax year) Subtotal (add lines 8 to 10; subtotal cannot be more than line 7) Balance of non-capital loss available to carry forward (line 7 minus line 11) Section 2 ­ Farming or fishing loss You can carry a farming or fishing loss back three tax years. Loss from farming or fishing (do not use brackets) Income from farming or fishing Subtotal (line 12 minus line 13; if negative, enter "0") Farming or fishing loss available to carry back (enter the amount from line 6) (enter tax year) Subtract: Farming or fishing loss to be applied to Farming or fishing loss to be applied to (enter tax year) Farming or fishing loss to be applied to (enter tax year) Subtotal (add lines 16 to 18; subtotal cannot be more than line 15) Balance of farming or fishing loss available to carry forward (line 15 minus line 19)
T3A E (09) (Ce formulaire est disponible en français)

Nil Nil
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Nil Nil Nil Nil
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1 3

2 4 5 6 7

q q e e q

8 9 10 11
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12 13 14 15

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16 17 18 19
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Section 3 ­ Net capital loss You can carry a net capital loss back three tax years. You can apply a net capital loss in an earlier year to the extent that the trust's taxable capital gains exceed its allowable capital losses for the earlier year. If you apply a net capital loss to a previous year, you cannot reduce the total amount originally allocated to a beneficiary for that year. However, you may have to change the portion of the total amount that was designated as a taxable capital gain. Note: The net capital loss is the excess of the losses on line 21 of Schedule 1, Dispositions of Capital Property and line 25 of Form T1055, Summary of Deemed Dispositions, over the gains at those lines. To determine the amount available to carry back, see Chapter 5 in Guide T4037, Capital Gains. Net capital loss available to carry back (see Note above) (enter tax year) Subtract: Net capital loss to be applied to Net capital loss to be applied to (enter tax year) Net capital loss to be applied to (enter tax year) Subtotal (add lines 21 to 23; subtotal cannot be more than line 20) Balance of net capital loss available to carry forward (line 20 minus line 24) 20
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21 22 23 24

Section 4 ­ Listed personal property (LPP) loss You can carry an LPP loss back against LPP gains for three tax years. Excess of LPP losses over LPP gains for the year available to carry back LPP loss to be applied to LPP net gains in (enter tax year) LPP loss to be applied to LPP net gains in (enter tax year) LPP loss to be applied to LPP net gains in (enter tax year) Subtotal (add lines 26 to 28; subtotal cannot be more than line 25) Balance of listed personal property loss available to carry forward (line 25 minus line 29) Subtract:
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25 26 27 28 29

Section 5 ­ Restricted farm loss You can carry a restricted farm loss back three tax years. Restricted farm loss for the year (see Guide T4003, Farming Income or Guide RC4060, Farming Income and the AgriStability and AgriInvest Programs) Subtract: Restricted farm loss to be applied to (enter tax year) Restricted farm loss to be applied to (enter tax year) Restricted farm loss to be applied to (enter tax year) Subtotal (add lines 31 to 33; subtotal cannot be more than line 30) Balance of restricted farm loss available to carry forward (line 30 minus line 34)
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30 31 32 33 34
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Does the trust have a balance of unpaid tax from another tax year?

Yes

No

Certification I,
(print name)

, certify that the information given on this form is, to the best of

my knowledge, correct and complete. ­
Date Signature of authorized person Position or title

­
Telephone

Privacy Act, Personal Information Bank number CRA PPU 015