Request for the Canada Revenue Agency to update records
Complete the information below concerning the deceased.
Name of deceased : __________________________________________
Deceased's social insurance number : _____ _____ _____
The deceased's date of birth : Year ___ Month ___ Day ___
The deceased's date of death : Year ___ Month ___ Day ___
Deceased's address : __________________________________________
Complete the applicable information below concerning the
surviving spouse or common-law partner.
Name of surviving spouse or common-law partner : _____________________________________
Surviving spouse's or common-law partner's social insurance number : _____ _____ _____
Signature of surviving spouse or common-law partner: ____________________ Date : ____________
Your name : __________________________________________
Your telephone number : _________________
Your address : __________________________________________
Your relationship to the deceased Footnote 1 :__________________________________________
Mail this form to the deceased’s tax centre. You can find the mailing addresses of our tax centres,
at Tax centres.
Personal information (including the SIN as a personal identifier) is collected for the purposes of the administration or enforcement of the Income Tax Act and related programs and activities. This includes administering benefits, audit, compliance, and collection activities. It may be shared or verified with other federal, provincial, territorial or foreign government institutions to the extent authorized by law. Failure to provide this information may result in interest payable, penalties or other actions. Under the Privacy Act, individuals have the right to access their personal information, request correction, or file a complaint to the Privacy Commissioner of Canada regarding the handling of the individual’s personal information. Refer to Info Source, Personal Information Bank CRA PPU 005.
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