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Flag Canada Revenue
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Agence du revenu
du Canada
Protected B when completed
Request for Loss Carryback by a Trust
 
Use this form to claim a loss carryback by a trust under sections 111 and 41 of the Income Tax Act. Section 80 of the Act may reduce the amount of loss to be
carried over.
Complete and file one copy of this form by the filing due date of the trust's income tax return for the year in which the loss occurred. You can file this form
separately or include it with the T3 return for the year of the loss.
If you want to claim a loss carryforward in a future year, you have to claim the carryforward on a T3 return for a year after the year of the loss.
Losses can be carried back to the three previous tax year-ends. If you apply a loss to a return for a previous year, you will not reduce any late-filing penalty
that applies to the T3 return for the tax year to which you apply the loss.
For more information, see lines 33 and 34 in Guide T4013, T3 Trust Guide. You can get the guide at canada.ca/cra-forms-publications.
 
 Name of trust 66100 Fiscal Period End  Trust account number
  T
 
Section 1 – Non-capital loss
Use the amounts from the T3 return for the loss year unless otherwise specified. Enter all the amounts without brackets.
When you calculate the income or loss from the sources listed below, the amounts you deducted on lines 14 and 17 and certain amounts deducted on line 11
of the T3 return (except those listed in Note 1 below) will reduce the income or increase the loss from any sources to which they relate.
  Notes
  1. Include all deductions that are not attributable to any particular source of income. This includes refund interest repaid and legal fees paid for advice
or help to object to, or appeal, an assessment under the Income Tax Act.
  2. Add the dividend gross-up amount (from line 30 of the T3 return) to dividends included in calculating investment income or loss.
  Income Loss
 
Taxable capital gains     Nil    
Capital gains deduction   Nil     +  
Pension income   +   Nil    
Investment income or loss (see Note 2 above)   +   +  
Business income or loss   +   +  
Farming or fishing income or loss (do not include restricted farm losses — see Section 5)   +   +  
Rental income or loss   +   +  
AgriInvest Fund 2 (for more information, see line 9 under Chapter 2 in Guide T4013, T3 Trust Guide)   +   Nil    
Deemed dispositions from Form T1055   +   Nil    
Other income   +   Nil    
Allowable business investment losses   Nil     +  
Treaty-exempt income (from line 35 of the T3 return)   Nil     +  
Net capital losses of other years (from line 34 of the T3 return)   Nil     +  
Subtotals   =  1 =  2
Other deductions (see Note 1 above)    3
Subtotal (line 1 minus line 3; if negative, enter "0")   =  4
Subtotal (line 2 minus line 4; if negative, enter "0")   =  5
Amount from line 5 or line 14, whichever is less    6
Total non-capital loss for the year (line 5 minus line 6; if negative, enter "0")   =  7
Subtract:
  Non-capital loss to be applied to the first previous tax year-end 66270  8
  Non-capital loss to be applied to the second previous tax year-end 66260 +  9
  Non-capital loss to be applied to the third previous tax year-end 66250 +  10
  Subtotal (add lines 8 to 10; subtotal cannot be more than line 7)   =  11
  Balance of non-capital loss available to carry forward (line 7 minus line 11)   =  
 
Section 2 – Farming or fishing loss
 
Loss from farming or fishing (do not use brackets)    12
Income from farming or fishing    13
Subtotal (line 12 minus line 13; if negative, enter "0")   =  14
Farming or fishing loss available to carry back (enter the amount from line 6)    15
 
Subtract:
  Farming or fishing loss to be applied to the first previous tax year-end 66320  16
  Farming or fishing loss to be applied to the second previous tax year-end 66310 +  17
  Farming or fishing loss to be applied to the third previous tax year-end 66300 +  18
  Subtotal (add lines 16 to 18; subtotal cannot be more than line 15)   =  19
  Balance of farming or fishing loss available to carry forward (line 15 minus line 19)   =  
 
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Protected B when completed
Section 3 – Net capital loss
You can apply a net capital loss in an earlier year to the extent that the trust's taxable capital gains exceed its allowable capital losses for the earlier year.
  Note
  The net capital loss is the excess of the losses on line 24 of Schedule 1, Dispositions of Capital Property and line 11 of Form T1055, Summary of
Deemed Dispositions, over the gains on those lines. To determine the amount available to carry back, see Chapter 5 in Guide T4037, Capital Gains.
 
Net capital loss available to carry back (see Note above)    20
Subtract:
  Net capital loss to be applied to the first previous tax year-end 66380  21
  Net capital loss to be applied to the second previous tax year-end 66370 +  22
  Net capital loss to be applied to the third previous tax year-end 66360 +  23
  Subtotal (add lines 21 to 23; subtotal cannot be more than line 20)   =  24
  Balance of net capital loss available to carry forward (line 20 minus line 24)   =  
Section 4 – Listed personal property (LPP) loss
Excess of LPP losses over LPP gains for the year available to carry back    25
Subtract:
  LPP loss to be applied to LPP net gains in the first previous tax year-end 66440  26
  LPP loss to be applied to LPP net gains in the second previous tax year-end 66430 +  27
  LPP loss to be applied to LPP net gains in the third previous tax year-end 66420 +  28
  Subtotal (add lines 26 to 28; subtotal cannot be more than line 25)   =  29
  Balance of listed personal property loss available to carry forward (line 25 minus line 29)   =  
 
Section 5 – Restricted farm loss
Restricted farm loss for the year (see Chapter 6 – Losses in Guide T4002, Self-employed Business,
Professional, Commission, Farming, and Fishing Income)    30
Subtract:
  Restricted farm loss to be applied to the first previous tax year-end 66500  31
  Restricted farm loss to be applied to the second previous tax year-end 66490 +  32
  Restricted farm loss to be applied to the third previous tax year-end 66480 +  33
  Subtotal (add lines 31 to 33; subtotal cannot be more than line 30)   =  34
  Balance of restricted farm loss available to carry forward (line 30 minus line 34)   =  
 
 
  Does the trust have a balance of unpaid tax from another tax year? 66800 Yes 1 No  2
 
 
 
  Has Form T3-ADJ been filed to include a subsection 104(13.1) or (13.2) designation
  for a prior year such that the loss that is being requested to be carried back will offset 66810 Yes 1 No  2
  the income inclusion for that year?
 
 
Certification
 
I,  , certify that the information given on this form is correct and complete.
Print name  
 
  66550          
  Date   Signature of authorized person Position or title Telephone number
 
 
See the privacy notice on your return.
 
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