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Agency
  加拿大税务局   加拿大税务局
 
个人所得税和福利申报的电子申报信息
 
纳税年份: 2023
 
The information on this form relates to the tax year shown in the top right corner. Before you fill out this form, read the information and instructions section below.
Fill out this form only if you want to authorize your electronic filer to create a pre-authorized debit agreement for you with the CRA, to schedule your Individual
Income Tax payment on filing for the current tax year only. The individual identified in Part A (or the individual's legal representative) must sign Part B. Your
electronic filer must fill out Part C. Give the signed original of this form to your electronic filer and keep a copy for yourself.
 
Part A – Identification and address as shown on your tax return
  名字 社会保险号码
 
  Mailing address: Apt number – Street number and Street name 邮箱 RR 城市 省/区 邮政编码
 
Part B – Pre-authorized debit agreement
  Do you want to pre-authorize the Canada Revenue Agency (CRA) to withdraw a specified amount from your bank account? If yes, fill in the
information below:
  I hereby authorize the electronic filer identified in Part C below to create this personal pre-authorized debit on my behalf. I authorize the CRA to automatically
withdraw the funds from my bank account as shown in the agreement details below. I also acknowledge that I have read and understood the information about
pre-authorized debits below.
 
         
 
  Signature (individual identified in Part A or legal representative)   Name and title of legal representative   日期  
 
  One-time payment for your Income Tax and Benefit Return, to be withdrawn on  for the amount of  
  日期  
  Branch number Institution number Account number  
 
 
Part C – Electronic filer identification
  By signing Part B above, I declare that the following person or firm is creating a personal pre-authorized debit agreement for the person named in Part A.
 
  Name of person or firm: Electronic filer number:   
 
Privacy Act, personal information bank number CRA PPU 005
 
Information and instructions
 
Part B – Pre-authorized debit agreement Recourse rights
Pre-authorized debit (PAD) is an online payment option. Through this option,
you agree to authorize the CRA to withdraw a pre-determined amount from
your bank account to pay tax on a specific date.


Cancelling or modifying your PAD
If you would like to cancel or make changes to your PAD agreement, go
to canada.ca/my-cra-account and select "CRA Sign in/Register". Any
changes made will require five business days to take effect. You can also
submit your request to the CRA by fax at 204-983-0924 or mail it to the
following address:
You have certain recourse rights if any debit does not comply with this
agreement. For example, you have the right to receive reimbursement for any
debit that is not authorized or is not consistent with this PAD Agreement. For
more information on your recourse rights, contact your financial institution or
visit payments.ca.


Account authorization
You guarantee that you have full authority for completing a pre-authorized
debit from your bank account.
 
PAD Unit
Revenue Processing Section
Winnipeg Tax Centre
66 Stapon Road
Winnipeg MB R3C 3M2
Please note that changes submitted to the CRA by fax or mail may take up to
30 days to take effect. If you do not inform the CRA of such changes on time,
you may be subject to a fee if the financial institution is unable to process a
debit according to your agreement.
 
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