Statement of Income and Expenses and Assets and Liabilities for Individuals

You must provide full financial disclosure to support your request to cancel or waive interest or penalties based on an inability to pay or financial hardship.

We recommend you use Form RC376 Taxpayer Relief Request - Statement of Income and Expenses and Assets and Liabilities for Individuals to provide full financial disclosure. This form provides instructions and examples of supporting documentation to submit with the relief request.

You do not have to use Form RC376. The Canada Revenue Agency (CRA) will not deny a relief request because a taxpayer did not use this form.

If you do not use our form and, instead, prepare and submit your own financial statements to support your request for interest or penalty relief, you can use our form to help you determine the information you need to provide.

Submit your full financial disclosure information (either Form RC376 or your own statements) together with your written request for relief (you may use Form RC4288, Request for Taxpayer Relief - Cancel or Waive Penalties or Interest) to the appropriate CRA designated office. Please see Submitting your request for designated office addresses.

Report a problem or mistake on this page
Please select all that apply:

Thank you for your help!

You will not receive a reply. For enquiries, contact us.

Date modified: