Request for the Canada Revenue Agency to update records
Complete the information below concerning the deceased.
Name of deceased:
Deceased’s social insurance number:
The deceased’s date of birth:
The deceased’s date of death:
Complete the applicable information below concerning the surviving spouse or common-law partner
Please reassess the surviving spouse’s or common-law partner’s return to allow a claim for the
GST/HST credit if the death occurred in 2013 or a prior year.
Name of surviving spouse or common-law partner:
Surviving spouse’s or common-law partner’s social insurance number:
Signature of surviving spouse or common-law partner:
Your telephone number:
Your relationship to the deceased*:
*In addition to any personal relationship you may have had with the deceased, please specify whether you are
the executor, administrator, or liquidator, or if you are acting in some other capacity.
Mail this form to the deceased’s tax centre. You can find the mailing addresses of our tax centres, at
Personal information, including the social insurance number, is collected under the Income Tax Act to assess individual income tax for the federal
government and the provinces and territories. It can be used for audit, compliance, or evaluation purposes and shared or verified with other federal and
provincial/territorial government institutions. Failure to provide the information may result in interest payable, penalties, or other actions.
Under the Privacy Act, individuals have a right to and shall, on request, be given access to their personal information and to request correction of it; refer to
InfoSource ( ), personal information bank CRA PPU 005.