Protected B when completed

Larry(Shima Nazari) Smith SIN: *** **5 555

Part B - Federal non-refundable tax credits (continued)
Enter the amount from line 81 of the previous page. 16,103 00 82
Base CPP or QPP contributions (complete Schedule 8 or Form RC381, whichever applies):
through employment income 30800 2,875 95 D 83
on self-employment income and other earnings 31000 D 84
Employment insurance premiums:
through employment
(boxes 18 and 55 of all T4 slips) (maximum $889.54) 31200 889 54 D 85
on self-employment and other eligible earnings
(complete Schedule 13) 31217 D 86
Volunteer firefighters' amount 31220 87
Search and rescue volunteers' amount 31240 88
Canada employment amount:
Enter whichever is less: $1,257 or line 1 plus line 2. 31260 1,257 00 89
Home buyers' amount (maximum $5,000) 31270 90
Home accessibility expenses (use Federal Worksheet) (maximum $10,000) 31285 91
Adoption expenses 31300 16,729 00 92
Digital news subscription expenses
(see line 31350 of the guide) (maximum $500) 31350 93
Add lines 83 to 93. 21,751 49 Y 21,751 49 94
Pension income amount (use Federal Worksheet) (maximum $2,000) 31400 95
Add lines 82, 94, and 95. 37,854 49 96
Disability amount for self
(if you were under 18 years of age, use Federal Worksheet; if not, claim $8,662) 31600 97
Disability amount transferred from a dependant (use Federal Worksheet) 31800 11,674 00 98
Add lines 96 to 98. 49,528 49 99
Interest paid on your student loans (see Guide P105) 31900 100
Your tuition, education, and textbook amounts (complete Schedule 11) 32300 101
Tuition amount transferred from a child or grandchild 32400 3,808 00 102
Amounts transferred from your spouse or common-law partner (complete Schedule 2) 32600 103
Add lines 99 to 103. 53,336 49 104
Medical expenses for self, spouse or common-law partner, and
your dependent children born in 2004 or later 33099 105
Amount from line 23600 127,169 50 x 3% = 3,815 09 106
Enter whichever is less: $2,421 or the amount from line 106. 2,421 00 107
Line 105 minus line 107 (if negative, enter ''0'') 108
Allowable amount of medical expenses for other dependants
(use Federal Worksheet) 33199 109
Line 108 plus line 109 33200 Y 110
Line 104 plus line 110 33500 53,336 49 111
Federal non-refundable tax credit rate 15% 112
Line 111 multiplied by the percentage from line 112 33800 8,000 47 113
Donations and gifts (complete Schedule 9) 34900 2,437 00 114
Line 113 plus line 114 Total federal non-refundable tax credits 35000 10,437 47 115

5006-R E (21)
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Page 6 of 8
 Protected B when completed
Larry(Shima Nazari) Smith SIN: *** **5 555
Part C - Net federal tax
Enter the amount from line 73. 17,223 65 116
Federal tax on split income (complete Form T1206) 40424 D 117
Line 116 plus line 117 40400 17,223 65 118
Amount from line 35000 10,437 47 119
Federal dividend tax credit (use Federal Worksheet) 40425 150 20 D 120
Minimum tax carryover (complete Form T691) 40427 D 121
Add lines 119 to 121. 10,587 67 Y 10,587 67 122
Line 118 minus line 122 (if negative, enter ''0'') Basic federal tax 42900 6,635 98 123
Federal surtax on income earned outside Canada (complete Form T2203) 124
Line 123 plus line 124 6,635 98 125
Federal foreign tax credit (complete Form T2209) 40500 126
Line 125 minus line 126 6,635 98 127
Recapture of investment tax credit (complete Form T2038(IND)) 128
Line 127 plus line 128 6,635 98 129
Federal logging tax credit (see guide) 130
Line 129 minus line 130 (if negative, enter ''0'') Federal tax 40600 6,635 98 D 131
Federal political contribution tax credit (use Federal Worksheet)
Total federal political contributions
(attach receipts) 40900 (maximum $650) 41000 D 132
Investment tax credit (complete Form T2038(IND)) 41200 D 133
Labour-sponsored funds tax credit (see line 41400 of the guide)
Net cost of shares of a provincially
registered fund 41300 Allowable credit 41400 D 134
Add lines 132 to 134. 41600 Y 135
Line 131 minus line 135 (if negative, enter ''0'') 41700 6,635 98 136
Canada workers benefit advance payments received (box 10 of the RC210 slip) 41500 D 137
Special taxes (see line 41800 of the guide) 41800 D 138
Add lines 136 to 138. Net federal tax 42000 6,635 98 139

Step 6 - Refund or balance owing

Amount from line 42000 6,635 98 140
CPP contributions payable on self-employment income and other earnings
(complete Schedule 8 or Form RC381, whichever applies) 42100 D141
Employment insurance premiums payable on self-employment and other eligible earnings
(complete Schedule 13) 42120 142
Social benefits repayment (amount from line 23500) 42200 143
Provincial or territorial tax
(complete and attach your provincial or territorial Form 428, even if the result is ''0'') 42800 4,880 26 D144
Add lines 140 to 144. Total payable 43500 11,516 24 D145

5006-R E (21)
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 Name of taxpayer Social Insurance Number Printed
Larry(Shima Nazari) Smith *** **5 555 2022/12/08
Protected B when completed
T1-2021 Capital Gains (or Losses) Schedule 3
Complete this schedule to report your taxable capital gains on line 12700 of your return. If you need more space, attach a
separate sheet. Attach a copy of this schedule to your paper return.
For more information about capital gains (or losses), including business investment losses, see Guide T4037, Capital Gains.
If you realized a gain on a disposition, you may be able to claim a capital gains deduction on line 25400 of your return.
If you have capital gains (or losses) on your T5, T5013, T4PS, and T3 information slips, report them on line 17400 or line 17600
of this schedule.
(1) (2) (3) (4) (5)
Property type Year of Proceeds of Adjusted cost Outlays and Gain (or loss)
acquisition disposition base expenses (from (column 2 minus
dispositions) columns 3 and 4)

1. Qualified small business corporation shares

Number Name of corp. and class of shares (1) (2) (3) (4) (5)

Total 10699 Gain (or loss) 10700 <NIL> 1

2. Qualified farm or fishing property
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 10999 Gain (or loss) 11000 <NIL> 2

Mortgage foreclosures and conditional sales repossessions
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 12399 Gain (or loss) 12400 <NIL> 3

3. Publicly traded shares, mutual fund units, deferral of eligible small business corporation shares, and other shares
Number Name of fund/corp. and class of shares (1) (2) (3) (4) (5)

xyz Co. 50,000 00 30,000 00 20,000 00

Total 13199 50,000 00 Gain (or loss) 13200 20,000 00 4
4. Real estate, depreciable property, and other properties (see the next page for principal residence)
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 13599 Gain (or loss) 13800 <NIL> 5

5. Bonds, debentures, promissory notes, and other similar properties
Face value Maturity date Name of issuer (1) (2) (3) (4) (5)

Total 15199 Gain (or loss) 15300 <NIL> 6

6. Other mortgage foreclosures and conditional sales repossessions
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 15499 Gain (or loss) 15500 <NIL> 7

7. Personal-use property (see the next page for principal residence)
(Provide full description)
(1) (2) (3) (4) (5)

Gain only 15800 <NIL> 8

8. Listed personal property (LPP) (LPP losses can only be applied against LPP gains)
(Provide full description)
(1) (2) (3) (4) (5)

Painting 8,000 00 200 00 7,800 00

Subtract: unapplied LPP losses from other years <NIL>
Net gain only 15900 7,800 00 9
Add lines 1 to 9. Total of gains (or losses) of qualified properties and other properties 27,800 00 10

5000-S3 E (21) G
 Name of taxpayer Social Insurance Number Printed
Larry(Shima Nazari) Smith *** **5 555 2022/12/08
Protected B when completed

Amount from line 10 of the previous page 27,800 00 11

Capital gains deferral from qualifying dispositions of eligible small business corporation shares
included on line 4 of the previous page 16100 12
Line 11 minus line 12 27,800 00 13
Capital gains (or losses) from T5, T5013, and T4PS information slips 17400 14
Capital gains (or losses) from T3 information slips 17600 15
Add lines 13 to 15. 27,800 00 16
Capital loss from a reduction in your business investment loss 17800 17
Total of all gains (or losses) before reserves
line 16 minus line 17 19100 27,800 00 18
Reserves from line 67060 of Form T2017 (if negative, show in brackets and subtract) 19200 19
Total capital gains (or losses)
line 18 plus line 19 19700 27,800 00 20
Applicable rate 50% 21
Line 20 multiplied by the percentage on line 21
If the result is positive, enter it on line 12700 of your return. Taxable capital gains
If the result is negative (loss), read the instructions below. (or net capital loss) in 2021 19900 13,900 00 22

If the amount on line 22 is negative (loss), do not report the amount on line 12700 of your return. Your latest notice of assessment
or reassessment will give you the amount of the loss that you can use to reduce your taxable capital gains of other years.
If you have a net capital loss in 2021 and would like to apply it against the taxable capital gains that you reported on your
2018, 2019, or 2020 return, complete Form T1A, Request for Loss Carryback.
You can carry forward your net capital losses indefinitely and apply them against your taxable capital gains in the future.

Principal residence
Complete this part if you disposed of a property (or properties) in 2021 that you are claiming a principal residence exemption for.
Also complete Form T2091(IND), Designation of a property as a principal residence by an individual, or Form T1255,
Designation of a Property as a Principal Residence by the Legal Representative of a Deceased Individual, whichever applies.
Even if you do not sell your property, you may have a deemed disposition that you must report. A deemed disposition
occurs when you are considered to have disposed of property even though you did not actually sell it. For example, a deemed
disposition may occur when you change how you use your principal residence, such as when you change all or part of your
principal residence to a rental or business operation, or change your rental or business operation to a principal residence.
If you were not a resident of Canada for the entire time you owned the designated property, your period of non-residence may
reduce or eliminate the amount of the principal residence exemption. For more information, call the CRA at 1-800-959-8281.

Principal residence designation

Tick the box that applies to your designation of the property described on Form T2091(IND) or Form T1255.
I designate the property to have been my principal residence for all years owned or for all years owned
17900 1
except one year in which I replaced my principal residence.

2 I designate the property to have been my principal residence for some but not all years owned.

3 I designate the properties to have been my principal residences for some or all of the years owned.

See the privacy notice on your return.

5000-S3 E (21) G
 Name of taxpayer Social Insurance Number Printed
Larry(Shima Nazari) Smith *** **5 555 2022/12/08
Protected B when completed

Part 4 - Net income (loss) before adjustments

Gross business or professional income (line 8299 of Part 3C) or Gross profit (line 8519 of Part 3D) . . . . . . . . . . . . . . 40,000 00 4A
Expenses (enter only the business part)
Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8521 4B
Meals and entertainment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8523 4C
Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8590 4D
Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8690 4E
Interest and bank charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8710 4F
Business taxes, licences, and memberships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8760 4G
Office expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8810 4H
Office stationery and supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8811 5,000 00 4I
Professional fees (includes legal and accounting fees) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8860 500 00 4J
Management and administration fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8871 4K
Rent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8910 4L
Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8960 4M
Salaries, wages, and benefits (including employer's contributions) . . . . . . . . . . . . . . . . . . . . . . 9060 4N
Property taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9180 4O
Travel expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9200 4P
Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9220 4Q
Fuel costs (except for motor vehicles) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9224 4R
Delivery, freight, and express . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9275 4S
Motor vehicle expenses (not including CCA) (amount 16 of Chart A) . . . . . . . . . . . . . . . . . . . . 9281 2,040 00 4T
Capital cost allowance (CCA). Enter amount i of Area A minus any personal part
and any CCA for business-use-of-home expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9936 1,200 00 4U
Other expenses (specify):
. 9270 4V
Total expenses: Total of amounts 4B to 4V 9368 8,740 00 Y 8,740 00
Net income (loss) before adjustments: Amount 4A minus line 9368 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9369 31,260 00
Part 5 - Your net income (loss)
Your share of line 9369 or the amount from your T5013 slip, Statement of Partnership Income. 31,260 00 5A
GST/HST rebate for partners received in the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9974
Total: Amount 5A plus line 9974 31,260 00 Y 31,260 00 5B
Other amounts deductible from your share of net partnership income (loss) (amount 6F) . . . . . . . . . . . . . . . . . . . . . . . . . . 9943
Net income (loss) after adjustments: Amount 5B minus line 9943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31,260 00 5C
Business-use-of-home expenses (amount 7P) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9945 600 00
Your net income (loss): Amount 5C minus line 9945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9946 30,660 00
Report the net income amount from line 9946 on the applicable line of your income tax and benefit return as indicated below:
D business income on line 13500
D professional income on line 13700
D commission income on line 13900

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 Name of taxpayer Social Insurance Number Printed
Larry(Shima Nazari) Smith *** **5 555 2022/12/08
Protected B when completed
Part 6 - Other amounts deductible from your share of net partnership income (loss)
Claim expenses you incurred that were not included in the partnership statement of income and expenses, and for which the
partnership did not reimburse you. These claims must not be included in the claims already calculated for the partnership.
List details of expenses: Expenses amounts
6A
6B
6C
6D
6E
Total other amounts deductible from your share of net partnership income (loss): Add amounts 6A to 6E
(enter this on line 9943 of Part 5) 6F

Part 7 - Calculating business-use-of-home expenses

Heat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7A
Electricity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,000 00 7B
Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,000 00 7C
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7D
Mortgage interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7E
Property taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,000 00 7F
Other expenses (specify): . 7G
Subtotal: Add amounts 7A to 7G 6,000 00 7H
Personal-use part of the business-use-of-home expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,400 00 7I
Subtotal: Amount 7H minus amount 7I 600 00 7J
Capital cost allowance (business part only), which means amount i of Area A minus
any portion of CCA that is for personal use or entered on line 9936 of Part 4 . . . . . . . . . . . . 7K
Amount carried forward from previous year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7L
Subtotal: Add amounts 7J to 7L 600 00 7M
Net income (loss) after adjustments (amount 5C) (if negative, enter ''0'') . . . . . . . . . . . . . . . . . 31,260 00 7N
Business-use-of-home expenses available to carry forward: Amount 7M minus amount 7N
(if negative, enter ''0'') . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7O
Allowable claim: Amount 7M or 7N above, whichever is less (enter your share of this amount on line 9945 of Part 5) . . . 600 00 7P

Part 8 - Details of other partners

Do not fill in this chart if you must file a partnership information return.
Name of partner Share of net income or (loss) Percentage of partnership
$ %
Address
Name of partner Share of net income or (loss) Percentage of partnership
$ %
Prov./Terr. Postal code
Address
Name of partner Share of net income or (loss) Percentage of partnership
$ %
Prov./Terr. Postal code
Address
Name of partner Share of net income or (loss) Percentage of partnership
$ %
Prov./Terr. Postal code
Address
Part 9 - Details of equity
Total business liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9931
Drawings in the current year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9932
Capital contributions in the current year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9933

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 Name of taxpayer Social Insurance Number Printed
Larry(Shima Nazari) Smith *** **5 555 2022/12/08
2021 Tax Summary
Identification: Larry(Shima Nazari)
Linda(Shima Naz
Income: Net employment earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90,000.00 40,000.00
Pension income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Elected split-pension amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Universal Child Care Benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dividends, interest and investment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,000.00 500.00
Rental income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39,500.00
Taxable capital gains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13,900.00
Self employed income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30,660.00
Workers' compensation / other federal payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total income 136,560.00 80,000.00
Net RPP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,000.00 1,000.00
Income: RRSP deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,600.00
Deduction for elected split-pension amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Universal Child Care Benefit repayment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Child care expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,000.00
Support payments / other deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290.50 182.50
Carrying charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,500.00
Employment expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net income 127,169.50 73,817.50
Taxable Deductions from net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30,000.00
Income: Taxable income 97,169.50 73,817.50
Tax Federal tax before non-refundable amounts ............................... 17,223.65 12,436.49
Payable: Non-refundable credits: Personal amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13,808.00 13,808.00
Family caregiver amount for children under 18 years of age . . . 2,295.00
CPP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,875.95 1,806.75
EI premiums through employment . . . . . . . . . . . . . . . . . . . . . . . 889.54 632.00
Allowable medical expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,785.47
Other amounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33,468.00 1,257.00
Subtotal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53,336.49 25,289.22
Non-refundable amounts (15%) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,000.47 3,793.38
Charitable donation credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,437.00
DTC / Min tax carry-over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150.20
Basic federal tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,635.98 8,643.11
Less: Federal credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net provincial / territorial tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,880.26 4,587.72
Total payable 11,516.24 13,230.83
Tax: Tax deducted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30,000.00 12,000.00
Credits: Provincial tax credits - Form 428/479 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Rent paid (for information purposes only) . . . . . . . . . .
Property taxes paid (for information purposes only) . .
Miscellaneous credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total credits 30,000.00 12,000.00
Balance due (refund) -18,483.76 1,230.83
Total amount due (refund) for the couple -17,252.93
GST/HST credit and provincial benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 0.00
Ontario Trillium Benefit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 0.00
Canada Child Benefit (July 2022 to June 2023) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 0.00
2022 RRSP contribution limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21,718.00 14,310.00

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 Protected B when completed
Linda(Shima Nazari) Smith SIN: *** **1 818
Part B - Federal non-refundable tax credits (continued)
Enter the amount from line 81 of the previous page. 13,808 00 82
Base CPP or QPP contributions (complete Schedule 8 or Form RC381, whichever applies):
through employment income 30800 1,806 75 D 83
on self-employment income and other earnings 31000 D 84
Employment insurance premiums:
through employment
(boxes 18 and 55 of all T4 slips) (maximum $889.54) 31200 632 00 D 85
on self-employment and other eligible earnings
(complete Schedule 13) 31217 D 86
Volunteer firefighters' amount 31220 87
Search and rescue volunteers' amount 31240 88
Canada employment amount:
Enter whichever is less: $1,257 or line 1 plus line 2. 31260 1,257 00 89
Home buyers' amount (maximum $5,000) 31270 90
Home accessibility expenses (use Federal Worksheet) (maximum $10,000) 31285 91
Adoption expenses 31300 92
Digital news subscription expenses
(see line 31350 of the guide) (maximum $500) 31350 93
Add lines 83 to 93. 3,695 75 Y 3,695 75 94
Pension income amount (use Federal Worksheet) (maximum $2,000) 31400 95
Add lines 82, 94, and 95. 17,503 75 96
Disability amount for self
(if you were under 18 years of age, use Federal Worksheet; if not, claim $8,662) 31600 97
Disability amount transferred from a dependant (use Federal Worksheet) 31800 98
Add lines 96 to 98. 17,503 75 99
Interest paid on your student loans (see Guide P105) 31900 100
Your tuition, education, and textbook amounts (complete Schedule 11) 32300 101
Tuition amount transferred from a child or grandchild 32400 102
Amounts transferred from your spouse or common-law partner (complete Schedule 2) 32600 103
Add lines 99 to 103. 17,503 75 104
Medical expenses for self, spouse or common-law partner, and
your dependent children born in 2004 or later 33099 10,000 00 105
Amount from line 23600 73,817 50 x 3% = 2,214 53 106
Enter whichever is less: $2,421 or the amount from line 106. 2,214 53 107
Line 105 minus line 107 (if negative, enter ''0'') 7,785 47 108
Allowable amount of medical expenses for other dependants
(use Federal Worksheet) 33199 109
Line 108 plus line 109 33200 7,785 47 Y 7,785 47 110
Line 104 plus line 110 33500 25,289 22 111
Federal non-refundable tax credit rate 15% 112
Line 111 multiplied by the percentage from line 112 33800 3,793 38 113
Donations and gifts (complete Schedule 9) 34900 <NIL> 114
Line 113 plus line 114 Total federal non-refundable tax credits 35000 3,793 38 115

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 Protected B when completed
Linda(Shima Nazari) Smith SIN: *** **1 818
Part C - Net federal tax
Enter the amount from line 73. 12,436 49 116
Federal tax on split income (complete Form T1206) 40424 D 117
Line 116 plus line 117 40400 12,436 49 118
Amount from line 35000 3,793 38 119
Federal dividend tax credit (use Federal Worksheet) 40425 D 120
Minimum tax carryover (complete Form T691) 40427 D 121
Add lines 119 to 121. 3,793 38 Y 3,793 38 122
Line 118 minus line 122 (if negative, enter ''0'') Basic federal tax 42900 8,643 11 123
Federal surtax on income earned outside Canada (complete Form T2203) 124
Line 123 plus line 124 8,643 11 125
Federal foreign tax credit (complete Form T2209) 40500 126
Line 125 minus line 126 8,643 11 127
Recapture of investment tax credit (complete Form T2038(IND)) 128
Line 127 plus line 128 8,643 11 129
Federal logging tax credit (see guide) 130
Line 129 minus line 130 (if negative, enter ''0'') Federal tax 40600 8,643 11 D 131
Federal political contribution tax credit (use Federal Worksheet)
Total federal political contributions
(attach receipts) 40900 (maximum $650) 41000 D 132
Investment tax credit (complete Form T2038(IND)) 41200 D 133
Labour-sponsored funds tax credit (see line 41400 of the guide)
Net cost of shares of a provincially
registered fund 41300 Allowable credit 41400 D 134
Add lines 132 to 134. 41600 Y 135
Line 131 minus line 135 (if negative, enter ''0'') 41700 8,643 11 136
Canada workers benefit advance payments received (box 10 of the RC210 slip) 41500 D 137
Special taxes (see line 41800 of the guide) 41800 D 138
Add lines 136 to 138. Net federal tax 42000 8,643 11 139

Step 6 - Refund or balance owing

Amount from line 42000 8,643 11 140
CPP contributions payable on self-employment income and other earnings
(complete Schedule 8 or Form RC381, whichever applies) 42100 D141
Employment insurance premiums payable on self-employment and other eligible earnings
(complete Schedule 13) 42120 142
Social benefits repayment (amount from line 23500) 42200 143
Provincial or territorial tax
(complete and attach your provincial or territorial Form 428, even if the result is ''0'') 42800 4,587 72 D144
Add lines 140 to 144. Total payable 43500 13,230 83 D145

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 Name of taxpayer Social Insurance Number Printed
Linda(Shima Nazari) Smith *** **1 818 2022/12/08
Protected B when completed
T1-2021 Capital Gains (or Losses) Schedule 3
Complete this schedule to report your taxable capital gains on line 12700 of your return. If you need more space, attach a
separate sheet. Attach a copy of this schedule to your paper return.
For more information about capital gains (or losses), including business investment losses, see Guide T4037, Capital Gains.
If you realized a gain on a disposition, you may be able to claim a capital gains deduction on line 25400 of your return.
If you have capital gains (or losses) on your T5, T5013, T4PS, and T3 information slips, report them on line 17400 or line 17600
of this schedule.
(1) (2) (3) (4) (5)
Property type Year of Proceeds of Adjusted cost Outlays and Gain (or loss)
acquisition disposition base expenses (from (column 2 minus
dispositions) columns 3 and 4)

1. Qualified small business corporation shares

Number Name of corp. and class of shares (1) (2) (3) (4) (5)

Total 10699 Gain (or loss) 10700 <NIL> 1

2. Qualified farm or fishing property
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 10999 Gain (or loss) 11000 <NIL> 2

Mortgage foreclosures and conditional sales repossessions
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 12399 Gain (or loss) 12400 <NIL> 3

3. Publicly traded shares, mutual fund units, deferral of eligible small business corporation shares, and other shares
Number Name of fund/corp. and class of shares (1) (2) (3) (4) (5)

Total 13199 Gain (or loss) 13200 <NIL> 4

4. Real estate, depreciable property, and other properties (see the next page for principal residence)
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 13599 Gain (or loss) 13800 <NIL> 5

5. Bonds, debentures, promissory notes, and other similar properties
Face value Maturity date Name of issuer (1) (2) (3) (4) (5)

Total 15199 Gain (or loss) 15300 <NIL> 6

6. Other mortgage foreclosures and conditional sales repossessions
Address or legal description Prov./Terr. (1) (2) (3) (4) (5)

Total 15499 Gain (or loss) 15500 <NIL> 7

7. Personal-use property (see the next page for principal residence)
(Provide full description)
(1) (2) (3) (4) (5)

Gain only 15800 <NIL> 8

8. Listed personal property (LPP) (LPP losses can only be applied against LPP gains)
(Provide full description)
(1) (2) (3) (4) (5)

Subtract: unapplied LPP losses from other years <NIL>

Net gain only 15900 <NIL> 9
Add lines 1 to 9. Total of gains (or losses) of qualified properties and other properties 10

5000-S3 E (21) G
 Name of taxpayer Social Insurance Number Printed
Linda(Shima Nazari) Smith *** **1 818 2022/12/08
Protected B when completed

Amount from line 10 of the previous page 11

Capital gains deferral from qualifying dispositions of eligible small business corporation shares
included on line 4 of the previous page 16100 12
Line 11 minus line 12 13
Capital gains (or losses) from T5, T5013, and T4PS information slips 17400 14
Capital gains (or losses) from T3 information slips 17600 15
Add lines 13 to 15. 16
Capital loss from a reduction in your business investment loss 17800 17
Total of all gains (or losses) before reserves
line 16 minus line 17 19100 18
Reserves from line 67060 of Form T2017 (if negative, show in brackets and subtract) 19200 19
Total capital gains (or losses)
line 18 plus line 19 19700 20
Applicable rate 50% 21
Line 20 multiplied by the percentage on line 21
If the result is positive, enter it on line 12700 of your return. Taxable capital gains
If the result is negative (loss), read the instructions below. (or net capital loss) in 2021 19900 22

If the amount on line 22 is negative (loss), do not report the amount on line 12700 of your return. Your latest notice of assessment
or reassessment will give you the amount of the loss that you can use to reduce your taxable capital gains of other years.
If you have a net capital loss in 2021 and would like to apply it against the taxable capital gains that you reported on your
2018, 2019, or 2020 return, complete Form T1A, Request for Loss Carryback.
You can carry forward your net capital losses indefinitely and apply them against your taxable capital gains in the future.

Principal residence
Complete this part if you disposed of a property (or properties) in 2021 that you are claiming a principal residence exemption for.
Also complete Form T2091(IND), Designation of a property as a principal residence by an individual, or Form T1255,
Designation of a Property as a Principal Residence by the Legal Representative of a Deceased Individual, whichever applies.
Even if you do not sell your property, you may have a deemed disposition that you must report. A deemed disposition
occurs when you are considered to have disposed of property even though you did not actually sell it. For example, a deemed
disposition may occur when you change how you use your principal residence, such as when you change all or part of your
principal residence to a rental or business operation, or change your rental or business operation to a principal residence.
If you were not a resident of Canada for the entire time you owned the designated property, your period of non-residence may
reduce or eliminate the amount of the principal residence exemption. For more information, call the CRA at 1-800-959-8281.

Principal residence designation

Tick the box that applies to your designation of the property described on Form T2091(IND) or Form T1255.
I designate the property to have been my principal residence for all years owned or for all years owned
17900 1
except one year in which I replaced my principal residence.

2 I designate the property to have been my principal residence for some but not all years owned.

3 I designate the properties to have been my principal residences for some or all of the years owned.

See the privacy notice on your return.

5000-S3 E (21) G
 Protected B when completed

Part 4 - Expenses
Total expenses Personal portion
Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8521
Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8690
Interest and bank charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8710 2,000 00 400 00
Office expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8810
Professional fees (includes legal and accounting fees) . . . . . . . . . . . . . 8860
Management and administration fees . . . . . . . . . . . . . . . . . . . . . . . . . . 8871
Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8960 40,000 00 8,000 00
Salaries, wages, and benefits (including employer's contributions) . . . . 9060
Property taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9180 3,000 00 600 00
Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9200
Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9220
Motor vehicle expenses (not including capital cost allowance) . . . . . . . . 9281
Other expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9270

Total expenses (add the lines listed under ''Total expenses'') . . . . . 45,000 00 A

Total for personal portion (add the lines listed under ''Personal portion'') . . . . . . . . . . . . . . . . . . . 9949 9,000 00

Deductible expenses (total expenses from amount A minus total personal portion on line 9949) . . . . . . . . . . . . . . . . . . . . . . 36,000 00 4
Net income (loss) before adjustments (total gross rental income from line 8299 minus deductible expenses from amount 4). 9369 54,000 00
Other expenses of the co-owners - calculate your share of net income from line 9369. Enter your result on amount 5 . . . . . . 5
Co-owners - other deductible expenses you have as a co-owner which you did not deduct elsewhere . . . . . . . . . . . . . . . . . . 9945
Subtotal (amount 5 minus line 9945) 54,000 00 6
Recaptured capital cost allowance (co-owners - enter your share of the amount) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9947
Subtotal (amount 6 plus line 9947) 54,000 00 7
Terminal loss (co-owners - enter your share of the amount) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9948
Subtotal (amount 7 minus line 9948) 54,000 00 8
Total capital cost allowance claim for the year (amount i from Area A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9936 14,500 00
Net income (loss) (amount 8 minus line 9936) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39,500 00 9
If you are a sole proprietor or a co-owner enter this amount on line 9946.
Partnerships
Partners - your share of amount 9, or the amount from your T5013 slip, Statement of Partnership Income . . . . . . . . . . . . . . 10
Partners - GST/HST rebate for partners received in the year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9974
Partners - other expenses of the partner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9943
Your net income (loss) - For sole proprietors or co-owners, enter this amount on your income tax and benefit return
on line 12600. For partnerships, enter the result of amount 10 plus line 9974 minus line 9943. Enter this amount on
your Income Tax and Benefit Return on line 12600 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9946 39,500 00

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 Name of taxpayer Social Insurance Number Printed
Linda(Shima Nazari) Smith *** **1 818 2022/12/08
Protected B
Capital Cost Allowance when completed
Area A - Calculation of capital cost allowance claim
1 2 3 4 5 6
Class Undepreciated Cost of additions Cost of additions from Proceeds of Adjustments UCC after
number capital cost in the year column 3 which are dispositions in additions and
(UCC) at (see Areas B and C) AIIPs or (ZEVs) the year (see Areas dispositions
the start Note 1 D and E) (2 + 3 - 5)
of the year

1 1.0 200000.00 200000.00

2 8.0 10,000.00 20,000.00 20,000.00 5,000.00 25,000.00
3
4
5
Total 210000.00 20,000.00 20,000.00 5,000.00 225000.00

7 8 9 10 11 12 13
Class Proceeds of UCC adjustment for Adjustment for Base amount CCA CCA for the year UCC at the end
number dispositions available current-year current-year for CCA rate (%) (10 multiplied of the year
to reduce additions additions of AIIPs and ZEVs additions subject to (6 + 8 - 9) 11 or a (6 - 12)
of AIIPs and ZEVs (4 - 7) multiplied the half-year rule lower amount
(5 - 3 + 4) by the relevant factor 1/2 x (3 - 4 - 5)
Note 2 Note 3

1 1.0 200000.00 4.00 8,000.00 192000.00

2 8.0 5,000.00 7,500.00 32,500.00 20.00 6,500.00 18,500.00
3
4
5
Total 5,000.00 7,500.00 232500.00 14,500.00 210500.00

* If you have a negative amount in column 6, add it to your income as a recapture under "Recaptured capital cost allowance" on line 9947. If
no property is left in the class and there is a positive amount in the column, deduct the amount from your income as a terminal loss under
"Terminal loss" on line 9948. Recapture and terminal loss do not apply to a class 10.1 property. For more information, see Chapter 3 of Guide T4036.
** For information on CCA for "Calculation of business-use-of-home expenses," see "Special situations" in Chapter 4 of Guide T4002, Self-employed
Business, Professional, Commision, Farming, and Fishing Income. To help you calculate the capital cost allowance claim, see the calculation charts in
Areas B to F.
*** Sole proprietors and partnerships - enter the total CCA claim for the year from amount i on line 9936.
Co-owners - enter only your share of the total CCA claim for the year from amount i on line 9936.

Note 1: Columns 4, 7, and 8 apply only to accelerated investment incentive properties (AIIPs) (see Regulation 1104(4) of the Income Tax Regulations
for the definition), zero-emission vehicles (ZEVs), zero-emission passenger vehicles (ZEPVs) and, under proposed legislation, other eligible
zero-emission automotive equipment and vehicles that become available for use in the year. In this chart, ZEV represents ZEV, ZEPV and other
eligible zero-emission automotive equipment and vehicles. An AIIP is a property (other than ZEV) that you acquired after November 20, 2018,
and became available for use before 2028. A ZEV is a motor vehicle included in Class 54 or 55 that you acquired after March 18, 2019, and became
available for use before 2028, or eligible zero-emission automotive equipment and vehicles included in Class 56 acquired after March 1, 2020, and
that became available for use before 2028. For more information, see Guide T4036.

Note 2: The proceeds of disposition of a ZEPV that has been included in Class 54 and that is subject to the $55,000 capital cost limit will be adjusted
based on a factor equal to the capital cost limit of $55,000 as a proportion of the actual cost of the vehicle. For dispositions after
July 29, 2019, the government proposes that the actual cost of the vehicle be adjusted for any payments or repayments of government
assistance that you may have received or repaid in respect of the vehicle. For more information on proceeds of disposition, read
"Class 54 (30%)" in Guide T4036.

Note 3: The relevant factors for properties available for use before 2024 are 2 1/3 (Classes 43.1, 54 and 56), 1 1/2 (Class 55), 1 (Classes 43.2 and 53),
0 (Classes 12 and 13), and 1/2 for the remaining accelerated investment incentive properties.

For more information on AIIP, CCA, ZEV and ZEPV, see Guide T4036 or go to canada.ca/taxes-accelerated-investment-income.

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