Form Nr74 E - Determination Of Residency Status (Entering Canada)

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DETERMINATION OF RESIDENCY STATUS (ENTERING CANADA)
Complete all areas of this form if you entered or stayed briefly in Canada. Give all the facts about your residency status while living in and outside Canada.
Mail only one completed copy of this form for the tax years in question (an additional form is not necessary for each tax year unless your situation changes, or
directed otherwise) to the International Tax Services Office, 2204 Walkley Road, Ottawa ON K1A 1A8. If you prefer, you can send the form by fax to
613-941-2505.
If you need help completing this form, see Interpretation Bulletin IT-221, Determination of an Individual's Residence Status, or call the International tax and
non-resident enquiries line at:
Calls from anywhere in Canada and the United States
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1-855-284-5942
Calls from outside Canada and the United States (we accept collect calls)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1-613-940-8495
You can find most forms and publications, as well as information on taxes, programs and credits, at our Web site.
Attach any necessary additional information to this form.
Identification
Last name
Usual first name and initial
Social insurance number (SIN)
Tax year
Canadian address
Telephone number
Do you want us to change our records to show this as your mailing address for all future correspondence?
In what province will you reside?
Yes
No
Mailing address ONLY (if different from above)
Citizenship
Date of entry
Marital status
Date of birth
Married
Living common-law
Widowed
DD
MM
YYYY
DD
MM
YYYY
Divorced
Separated
Single
Length of stay
How long do you expect to live in Canada?
Number of days:
Number of months:
Number of years:
When will you leave Canada? (if applicable)
Entered Canada permanently and have no plan to leave Canada.
General Information
Tick (✔) the box that applies to you:
You usually live in another country and you will be temporarily living in Canada for
days in the year, but will leave Canada during the year (we will calculate the
number of days if you give us the dates you will be in Canada).
You usually live in another country, but enter and leave Canada on the same day to work, shop, or study.
You usually live in Canada, but you leave Canada during the day to work, shop, or study in another country, and return to Canada the same day.
You have permanent resident (landed immigrant) status.
DD
MM
YYYY
You have applied for permanent resident (landed immigrant) status. Give the date of application:
You have been given permission by Citizenship and Immigration Canada to stay in Canada for an extended period.
You have a visa that allows you to be in Canada temporarily. Give the following information:
The type of visa you have:
Visa expiry date:
Do you plan to renew it?
Yes
No
We may ask you to give us a copy of the document from Citizenship and Immigration Canada that allows you to stay in Canada.
None of the above – explain:
Living outside Canada
Tick (✔) a box to indicate the reason you were living outside Canada:
You were a member of the Canadian Forces.
You were a member of the overseas Canadian Forces school staff who filed income tax returns as a resident of Canada.
You were a locally engaged employee (you lived outside of Canada after severing ties and were then hired locally) of a Canadian embassy or mission abroad.
NR74 E (12)

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