Please complete this form prior to dropping off your stuff (an option for current clients, only), or before arriving for your appointment!

     
   

Don't forget to include your Email Address!

Birthdate

Division/Platoon

Your Name    
Spouse's Name  

Spouse's Income

Names of Children  
Home address  
Number of km (average) for round trip home to station
Home Phone
 

Pager

Cell

** Email address **
Court
Number of off duty appearances    
Courses - Not at Your Div / Detach / District

Course Name

# Days

Rnd Trp Km's

Total Km's

 

 

     
Paid Duty
Total number of hours Total number of paid duties Total income
RRSPs

Contributor

LSF

Other

Total

Self      
Spouse      
Automobile Information
Is there any change from the prior year?

(if you have more than one vehicle, please answer each question for each vehicle)
 

Vehicle 1

Vehicle 2

Make/model    
Number of cylinders    
Purchase price    
If Leased,
monthly payment
   
If Financed    
Amount    
Date    
Term    
Interest rate    
Loan balance on January 1st    
Loan balance on December 31    
Repair and maintenance totals    
Insurance    
Licence     

2009 Home Renovation Credit Information
(January 28, 2009 through January 30, 2010)
(Use back of page or attach separate sheet if necessary)

Date

Supplier name

Supplier GST #

Amount paid

Description of work done

         
         
         
         
         
         
Other expenses
List any item "required" by regulation to preserve the law that the force will not supply or reimburse you for.
Safety deposit box cost  
Other  

And don't forget your signed T2200 and Paid Duty printout

       
       

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