Financial Statement Page 7
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8Schedule A
Additional Sources of Income
Income Source
Annual Amount
Line
Net partnership income
1.
$
Net rental income (Gross annual rental income of
)
2.
$
$
Total amount of dividends received from taxable Canadian corporations
3.
$
Total capital gains (
)
less capital losses (
) $
4.
$
$
Registered retirement savings plan withdrawals
5.
$
Income from a Registered Retirement Income Fund or Annuity
6.
$
Any other income
7.
$
(specify source)
Subtotal:
$
Schedule B
Other Income Earners in the Home
Complete this part only if you are making or responding to a claim for undue hardship or spousal support. Check and complete all sections that
apply to your circumstances.
1.
I live alone.
2.
I am living with
(full legal name of person you are married to or cohabiting with)
3.
I/we live with the following other adult(s):
4.
child(ren) who live(s) in the home.
I/we have
(give number)
5. My spouse/partner
works at
(place of work or business)
does not work outside the home.
6. My spouse/partner
earns
$
per
(give amount)
does not earn any income.
7.
My spouse/partner or other adult residing in the home contributes about $
per
towards the household expenses.
FLR-13-E (2015/01)
Page 7 of 8
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