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Protected B when completed  

Part B – Northwest Territories non-refundable tax credits

(continued)
Amount from line 24 of the previous page    25
Pension income amount (maximum $1,000) 58360 +  26
Caregiver amount (use Worksheet NT428) 58400 +  27
Add lines 25 to 27.   =  28
Disability amount for self
(claim $13,456 or, if you were under 18 years of age, use Worksheet NT428) 58440 +  29
   
Disability amount transferred from a dependant(use Worksheet NT428) 58480 +  30
Add lines 28 to 30.   =  31
Interest paid on your student loans (amount from line 31900 of your return) 58520 +  32
Your tuition and education amounts (attach Schedule NT(S11)) 58560 +  33
Tuition and education amounts transferred from a child or grandchild 58600 +  34
Amounts transferred from your spouse or common-law partner (attach Schedule NT(S2)) 58640 +  35
Add lines 31 to 35.   =  36
Medical expenses:
  Amount from line 33099 of your return 58689 37
  Amount from line 23600 of your return    38  
  Applicable rate   x                  3%  39  
  Line 38 multiplied by the percentage from line 39   =  40  
  Enter whichever is less: $2,635 or the amount on line 40.   – 41
  Line 37 minus line 41 (if negative, enter "0")   = 42
Allowable amount of medical expenses for other dependants  
(use Worksheet NT428) 58729 + 43
 
Line 42 plus line 43 58769 =  ► + 44
Line 36 plus line 44 58800 = 45
Northwest Territories non-refundable tax credit rate   x                  5.9% 46
Line 45 multiplied by the percentage from line 46 58840 = 47
 
Donations and gifts:
  Amount from line 13
  of your federal Schedule 9     x 5.9% =   48  
  Amount from line 14
  of your federal Schedule 9     x 14.05% =   + 49  
Line 48 plus line 49 58969 =  ► + 50
 
Line 47 plus line 50    
Enter this amount on line 55. Northwest Territories non-refundable tax credits 61500 = 51
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
5012-C E (23)   Page 2 of 3