Free t2092-04e.pdf - Canada

CONTRIBUTIONS TO A REGISTERED PARTY OR TO A REGISTERED ASSOCIATION INFORMATION RETURN To be completed by each registered agent, electoral district agent, terminated registered agent, or terminated electoral district agent of a registered party or registered association. In the event of death of a registered agent or electoral district agent, the return must be completed by the party's chief agent or by the association's financial agent, respectively. One completed return must be filed with the Charities Directorate, Canada Revenue Agency, Ottawa ON K1A 0L5. The return must be filed on or before: June 30 of the year following the period covered by the return, in the case of a registered party; or May 31 of the year following the period covered by the return, in the case of a registered association. A copy of each receipt signed by the registered agent or by the electoral district agent for monetary contributions to the registered party or registered association during the period covered by the return must be maintained by the registered agent or electoral district agent until the day that is two years after the end of the last calendar year to which the receipt relates, and must be available for inspection throughout that period. Identification (Print)
Name of Registered Party or Registered Association

Address of Registered Party or Registered Association

Name of Registered Agent or Electoral District Agent

Address of Registered Agent or Electoral District Agent

Period Covered by this Return From: (check ( 1. ) applicable box and enter appropriate date)

2.

The date following the end of the period last reported, if a previous return has been filed by the registered agent or electoral district agent, (or) the date of appointment of the registered agent or electoral district agent. . . . . . . . . . . . . . . ) applicable box and enter appropriate date)

Year

Month

Day

To: The earlier of: (check (

Year

Month

Day

(a) December 31 (indicate year), . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (or) (b) the date of termination or death of the registered agent or electoral district agent. . . . Contributions Received Before completing this part, please refer to the Canada Revenue Agency's Information Circular 75-2.
Year

12
Month

31
Day

(1)

Total amount of monetary contributions received during the period covered by this return . . . . . . . . . . $ Total eligible amount of monetary contributions received for which receipts for income tax purposes were issued . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Difference: If the amount at (1) is greater than the amount at (2), please attach a reconciliation . . . . . $ Questions 1. If replacement receipts were issued for spoiled receipts, or receipts were otherwise cancelled, were all original receipts returned to the registered agent or electoral district agent? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes If no, please provide particulars:
(2) (3)

No

2. If duplicate receipts were issued, were they in all cases issued to the original contributor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes If no, please provide particulars:

No

Certification I,
Name of Registered Agent or Electoral District Agent (Print)

hereby certify that I have not issued official tax receipts for

goods and/or services, and that the information given in this information return and in any documents attached is, to the best of my knowledge, correct and complete.
Signature of Registered Agent or of Chief Agent on Behalf of Deceased Registered Agent or Electoral District Agent or of Financial Agent on Behalf of Deceased Electoral District Agent. Home telephone number Business telephone number Date

T2092 (04)
Printed in Canada

Form authorized by the Minister of National Revenue (Français au verso)