Financial Statement Page 10
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10Schedule A: Additional Sources of Income
Line
Income Source
Annual Amount
1.
Net partnership income
$
2.
Net rental income (Gross annual rental income of $
)
$
3.
Total amount of dividends received from taxable Canadian corporations
$
4.
Total capital gains ($
) less capital losses ($
)
$
5.
Registered retirement savings plan withdrawals
$
6.
Income from a Registered Retirement Income Fund or Annuity
$
7.
Any other income
$
(specify source)
Subtotal:
$
Schedule B: Special or Extraordinary Expenses for the Child(ren)
Available Tax
Child’s Name
Expense
Amount/yr.
Credits or
Deductions*
1.
$
$
2.
$
$
3.
$
$
4.
$
$
5.
$
$
6.
$
$
7.
$
$
8.
$
$
9.
$
$
10.
$
$
Total Net Annual Amount
$
Total Net Monthly Amount
$
* Some of these expenses can be claimed in a parent’s income tax return in relation to a tax credit or deduction (for
example childcare costs). These credits or deductions must be shown in the above chart.
I earn $
per year which should be used to determine my share of the above expenses.
NOTE: Pursuant to the Child Support Guidelines, a court can order that the parents of a child share the costs of the following
expenses for the child:
•
Necessary childcare expenses;
•
Medical insurance premiums and certain health-related expenses for the child that cost more than $100 annually;
•
Extraordinary expenses for the child’s education;
•
Post-secondary school expenses; and,
•
Extraordinary expenses for extracurricular activities.
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FLR-13.1-E (2015/01)
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