Ontario Declaration of Residency/Consent Form

Ontario Declaration of Residency/Consent Form 2016

please collect this form for all individuals included in your labour expenditure claim.

please retain for your records for proof of residency.

(For activities personally undertaken by an individual in the calendar year from

January 1, 2016 to December 31, 2016)

Instructions: Please complete all sections of this form.

______the “Corporation”

(name of applicant company)

Name:______

S.I.N: ______ON Driver’s License #: ______

Occupation: ______

Address: __________

(full address including postal code)

I hereby certify and confirm that:

1.I was subject to personal income tax in Ontario in the calendar year 2015 by virtue of being resident in Ontario on the 31st day of December, 2015 and my address at that time was:

same as above

______

(full address including postal code)

2. I understand that the Corporation will be relying on this declaration for its application for an Ontario Computer Animation and Special Effects (OCASE) Tax Credit which is jointly administered by the Ontario Media Development Corporation (OMDC) and the Canada Revenue Agency and may be subject to government audit, and hereby warrant that the above-noted information is true and correct.

3. I understand that an OCASE Tax Credit is based on eligible Ontario labour expenditures incurred for eligible computer and special effects activities for use on an eligible production, and as such I hereby grant permission for the Corporation to supply to the Canada Revenue Agency information with respect to my work including, but not limited to, the information contained in this form; the number of hours worked, any and all remuneration I received for my work, and any other information necessary in order to determine that the remuneration I received for my work on the production(s) is an eligible labour expenditure as per section 125.4(1) of the Income Tax Act; and any information necessary in order to verify that I am an Ontario-based individual1.

4. The information, including documentation, obtained in connection with this Declaration/Consent is collected pursuant to Section 90 of the Taxation Act.The above-referenced information shall be used for the purpose of processing the Corporation’s application for an OCASE tax credit.

Signature of Declarant / Date

1“Ontario-based individual” means, in relation to eligible activities performed for an eligible production, an individual who, by reason of being an individual described in clause 2(a) of the Income Tax Act, is subject to tax under section 2 of that Act for the calendar year before the calendar year in which he or she undertook the activities.

Ontario Declaration of Residency/Consent Form 2015

please collect this form for all individuals included in your labour expenditure claim.

please retain for your records for proof of residency.

(For activities personally undertaken by an individual in the calendar year from

January 1, 2015 to December 31, 2015)

Instructions: Please complete all sections of this form.

______the “Corporation”

(name of applicant company)

Name:______

S.I.N: ______ON Driver’s License #: ______

Occupation: ______

Address: __________

(full address including postal code)

I hereby certify and confirm that:

1.I was subject to personal income tax in Ontario in the calendar year 2014 by virtue of being resident in Ontario on the 31st day of December, 2014 and my address at that time was:

same as above

______

(full address including postal code)

2. I understand that the Corporation will be relying on this declaration for its application for an Ontario Computer Animation and Special Effects (OCASE) Tax Credit which is jointly administered by the Ontario Media Development Corporation (OMDC) and the Canada Revenue Agency and may be subject to government audit, and hereby warrant that the above-noted information is true and correct.

3. I understand that an OCASE Tax Credit is based on eligible Ontario labour expenditures incurred for eligible computer and special effects activities for use on an eligible production, and as such I hereby grant permission for the Corporation to supply to the Canada Revenue Agency information with respect to my work including, but not limited to, the information contained in this form; the number of hours worked, any and all remuneration I received for my work, and any other information necessary in order to determine that the remuneration I received for my work on the production(s) is an eligible labour expenditure as per section 125.4(1) of the Income Tax Act; and any information necessary in order to verify that I am an Ontario-based individual1.

4. The information, including documentation, obtained in connection with this Declaration/Consent is collected pursuant to Section 90 of the Taxation Act.The above-referenced information shall be used for the purpose of processing the Corporation’s application for an OCASE tax credit.

Signature of Declarant / Date

1“Ontario-based individual” means, in relation to eligible activities performed for an eligible production, an individual who, by reason of being an individual described in clause 2(a) of the Income Tax Act, is subject to tax under section 2 of that Act for the calendar year before the calendar year in which he or she undertook the activities.

Ontario Declaration of Residency/Consent Form 2014

please collect this form for all individuals included in your labour expenditure claim.

please retain for your records for proof of residency.

(For activities personally undertaken by an individual in the calendar year from

January 1, 2014 to December 31, 2014)

Instructions: Please complete all sections of this form.

______the “Corporation”

(name of applicant company)

Name:______

S.I.N: ______ON Driver’s License #: ______

Occupation: ______

Address: __________

(full address including postal code)

I hereby certify and confirm that:

1.I was subject to personal income tax in Ontario in the calendar year 2013 by virtue of being resident in Ontario on the 31st day of December, 2013 and my address at that time was:

same as above

______

(full address including postal code)

2. I understand that the Corporation will be relying on this declaration for its application for an Ontario Computer Animation and Special Effects (OCASE) Tax Credit which is jointly administered by the Ontario Media Development Corporation (OMDC) and the Canada Revenue Agency and may be subject to government audit, and hereby warrant that the above-noted information is true and correct.

3. I understand that an OCASE Tax Credit is based on eligible Ontario labour expenditures incurred for eligible computer and special effects activities for use on an eligible production, and as such I hereby grant permission for the Corporation to supply to the Canada Revenue Agency information with respect to my workincluding, but not limited to, the information contained in this form; the number of hours worked, any and all remuneration I received for my work, and any other information necessary in order to determine that the remuneration I received for my work on the production(s)is an eligible labour expenditure as per section 125.4(1) of the Income Tax Act; and any information necessary in order to verify that I am an Ontario-based individual1.

4. The information, including documentation, obtained in connection with this Declaration/Consent is collected pursuant to Section 90 of theTaxation Act.The above-referenced information shall be used for the purpose of processing the Corporation’s application for an OCASE tax credit.

Signature of Declarant / Date

1“Ontario-based individual” means, in relation to eligible activities performed for an eligible production, an individual who, by reason of being an individual described in clause 2(a) of the Income Tax Act, is subject to tax under section 2 of that Act for the calendar year before the calendar year in which he or she undertook the activities.