Determination Of Residency Status (Leaving Canada) - Canada Revenue Agency (Page 3 of 4) in pdf

Which of the following ties will you have in Canada while living in another country? Tick (

) the boxes that apply to you. (continued)

You will continue to support a person in Canada who lives in a dwelling (e.g., a house, apartment, trailer, room, suite) that you occupied before your departure.

You did not own but you rented a dwelling in Canada. You will sublet it for the period of your absence from Canada, and you intend to renew the lease when it expires.

You will continue to own a dwelling in Canada that is suitable for year-round occupancy and:

keep the dwelling vacant;

rent the dwelling to a related person;

rent the dwelling on non-arm's length terms, (for example, under fair market value)

rent the dwelling without a written lease; or

rent the dwelling at arms length, at fair market value, and with a written lease. Explain:

You will keep the majority (or a significant part) of such things as your furniture, furnishings, appliances, and utensils) in Canada.

You will have personal possessions in Canada such as your clothing or personal items or pets.

You will keep vehicles in Canada that are registered in a province or territory of Canada.

You will keep your driver's licence from a province or territory of Canada.

You will have a valid Canadian passport.

You will have a guaranteed job available on your return to Canada.

You will be employed by a Canadian employer while outside Canada.

You will stay eligible for medical coverage from a province or territory of Canada for more than three months after you leave Canada. To find out whether or not you will be

eligible for provincial or territorial medical coverage while living outside Canada, contact the provincial or territorial health authorities where you live.

You will keep memberships in Canadian social, recreational, or religious organizations. List these memberships:

You will keep professional or union memberships in Canada that depend on Canadian residency. List these memberships:

You will keep bank accounts in Canada. Explain why you keep these accounts:

You will keep and use credit cards or debit cards issued by Canadian financial institutions.

You will have investments (RRSPs, securities accounts, etc.) in Canada. Describe these investments:

You will keep a seasonal residence in Canada (e.g., a cottage or chalet).

You will have a telephone listing or service in Canada. Even if it is not listed, give the address for any telephone service and indicate if it is a personal or business service:

You will use personal stationery or business cards with a Canadian address. Give the address you will use:

You will keep a mailing address, a post office box, or a safety deposit box in Canada. Give the address for these items:

You will have newspaper or magazine subscriptions sent to a Canadian address.

You will have subscriptions for life or general insurance, including health insurance, through a Canadian insurance company.

You will be involved with and have responsibilities in partnerships, corporate or business relationships, or endorsement contracts in Canada.

Specify:

You will keep landed immigrant status (if you are a landed immigrant) or a temporary work permit in Canada. Give the date of application for landed immigrant status or list the

type of visa you have and the expiry date.

You will have other ties with Canada. Describe them:

None of the items in this section apply to you.

Intention

Do you intend to return to Canada to live?

Yes

Please state your long-term career goals:

Note – If it is determined that you are a non-resident of Canada you are expected to pay or post acceptable security for departure tax and advise Canadian financial institutions

making payments to you that you may be subject to non-resident withholding taxes on certain income, i.e. dividends. For more information see form T1161 and guide T4061.

Visiting Canada

You will make return visits to Canada.

Yes

If yes, select which of the following best describes your visits to Canada.

Lengthy

Regular

Frequent

None of the above

Please provide details