Fillable Printable Child Benefit Application Form - Canada
Fillable Printable Child Benefit Application Form - Canada
Child Benefit Application Form - Canada
Canada Child Benefits Application
RC66 E (08)
Complete this form to apply for all child benefit programs.
The information you give on this form will be used for all
programs, unless you indicate otherwise on a note attached
to your application.
How to apply?
Complete and submit your application as soon as possible after
the child is born or begins to live with you, or when you become
a resident of Canada for income tax purposes.
Complete this form and send it, along with any other required
documents, to one of our tax centres listed on page 2 of this
information sheet.
Check "Married" if you have a spouse, or "Living common-law"
if you have a common-law partner. If you have been separated for
less than 90 days, you are still considered to be married or living
common-law. For more information, see the definitions on page 2
of this information sheet.
What is your current marital status?
Part 1 – Information about the applicant
For Canada Child Tax Benefit (CCTB) purposes, it is presumed
that when both a male and a female parent live in the
same home as the child, the female parent is considered to be
primarily responsible (see the definition on page 2 of this
information sheet) for the child(ren) and should apply. However,
if the male parent is primarily responsible, he can apply if he
attaches a signed note from the female parent to his application,
which states that the male parent is primarily responsible for the
child(ren).
The person who is primarily responsible for the care and
upbringing of the child(ren) should complete Part 1.
For information about our programs, see Pamphlet T4114,
Canada Child Benefits, Pamphlet RC4210, GST/HST Credit,
visit our Web site at www.cra.gc.ca/benefits, or call us at
1-800-387-1193.
Part 3 – Information about the child(ren)
Attach legible photocopies of both sides of all pages of one of
the following documents for proof of birth:
baptismal or cradle roll certificate or other church record;
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birth certificate or birth registration;
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hospital record of birth or record of the physician, nurse, or
midwife who attended the birth;
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passport;
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Record of Landing or Confirmation of Permanent Residence
issued by Citizenship and Immigration Canada;
the child was born outside Canada; or
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the child was born in Canada and is one year of age or older.
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Do not provide information about a child for whom you have
already applied, or for whom you receive benefits.
Complete this part to provide information about the child(ren).
You need to attach proof of birth for the child if we have not
previously paid benefits to anyone for this child, and any of the
following applies:
When do you need to provide proof of birth?
citizenship certificate; or
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Note
If a child left your care and has now returned to your care, you
have to provide information about that child again.
Notice of Decision or a Temporary Resident's Permit issued
under the Immigration and Refugee Protection Act.
Part 2 – Information about your spouse
or common-law partner
Complete Part 2 of the application only if you checked box 1 or 2
in Part 1.
Does your application include a period that started more than
11 months ago?
In order to receive payments, you must attach legible photocopies
of both sides of all pages of the following documents for the entire
period that started more than 11 months ago:
Who should complete Part 1?
Proof of citizenship status (for example, a Canadian birth
certificate) and/or immigration status in Canada for you
and your spouse or common-law partner (if you have one).
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Proof that you resided in Canada, such as a lease or rent
receipts, utility bills, or bank statements.
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Proof of birth for each child. See Part 3 of this form.
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Proof that you were the person who is primarily responsible
(see the definition on page 2 of this information sheet) for
the care and upbringing of the child(ren). This could include,
but is not limited to, a signed statement from a school,
daycare or nursery, a medical professional, or a lawyer.
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Note
If your application includes a period that started more than
11 months ago, it is considered late.
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Send us your completed Form RC66, Canada Child Benefits Application, and any required documents in the envelope
included with your package. If you do not have the preprinted envelope, send the information to one of the following
addresses:
Jonquière Tax Centre
PO Box 1900 Stn LCD
Jonquière QC G7S 5J1
Shawinigan-Sud Tax Centre
PO Box 3000 Stn Main
Shawinigan-Sud QC G9N 7S6
St. John's Tax Centre
PO Box 12071 Stn A
St. John's NL A1B 3Z1
Sudbury Tax Centre
PO Box 20000 Stn A
Sudbury ON P3A 5C1
Summerside Tax Centre
102-275 Pope Road
Summerside PE C1N 5Z7
Surrey Tax Centre
9755 King George Highway
Surrey BC V3T 5E1
Winnipeg Tax Centre
PO Box 14005 Stn Main
Winnipeg MB R3C 0E3
Tax centre addresses
Separated
You are separated when you start living separate and apart
from your spouse or common-law partner because of a
breakdown in the relationship and this separation lasts for at
least 90 days during which time you have not reconciled.
has been living with you in a conjugal relationship for
at least 12 continuous months;
is the parent of your child by birth or adoption; or
a)
b)
c)
has custody and control of your child (or had custody
and control immediately before the child turned
19 years of age) and your child is wholly dependent
on that person for support.
In addition, an individual immediately becomes your
common-law partner if you previously lived together in a
conjugal relationship for at least 12 continuous months and
you have resumed living together in such a relationship.
Under proposed changes, this condition will no longer
exist. The effect of this proposed change is that a person
(other than a person described in b) or c) above) will be
your common-law partner only after your current
relationship with that person has lasted at least
12 continuous months. This proposed change will apply
to 2001 and later years.
Reference to "12 continuous months" in this definition
includes any period that you were separated for less than
90 days because of a breakdown in the relationship.
Note: Once you have been separated for 90 days (due to
a breakdown in the relationship), the effective day of your
separated status is the day you started living separate and
apart.
Spouse
This applies only to a person to whom you are legally
married.
Primarily responsible
Primarily responsible for the care and upbringing of a child
means that you are responsible for such things as supervising
the child's daily activities and needs, making sure the child's
medical needs are met, and arranging for child care when
necessary. If there is a female parent who lives with the child,
we usually consider her to be this person. However, it could
be the father, a grandparent, or a guardian.
Common-law partner
This applies to a person who is not your spouse, with
whom you are living in a conjugal relationship, and to
whom at least one of the following situations applies.
He or she:
Definitions
Direct deposit
You can have your payments deposited directly into
your account at a financial institution in Canada.
To get this service, the applicant must complete and
attach Form T1-DD(1), Direct Deposit Request -
Individuals, to his or her application.
Additional information
Benefits application
Timeliness: Our goal is to issue payment, notice, or
explanation to you within 80 calendar days.
Benefits online calculator
You can use our online calculator to get an estimate of
your child benefits by visiting our Web site at
www.cra.gc.ca/benefits-calculator.
Part 4 – Change of recipient
Complete this part if the child(ren) had been living with another
individual or were maintained by an agency.
Part 5 – Certification
You have to sign and complete this part. If you completed Part 2,
your spouse or common-law partner also has to sign and complete
this part.
There are situations where a child may reside with two different
individuals on a more or less equal basis, and both of these
individuals share equally in the child's care and upbringing. If this
situation applies to you, attach a note to your application that clearly
states your parenting arrangement. For more information, visit our
Web site at www.cra.gc.ca/benefits, or call us at 1-800-387-1193.
Shared eligibility
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Married
12
Living common-law
3
Widowed
Province or territory (or country, if outside Canada)
Social insurance number
Date of birth
MonthYear Day
Apt No - Street No Street name
P.O. Box
City
Postal code
Last name
If you moved to this address within the last 12 months, enter the date you moved
MonthYear Day
. . . . . . . . . . . . . . . . .
If you moved from a different province or territory, name the previous province or territory
5
Separated
Divorced
Single
4
. . . . . . . . .
Month
Year
Check the box that applies to your current marital status.
Telephone numbers:
Work
Français
Mailing address:
Home address (if different from above):
Province or territory (or country, if outside Canada)
Apt No - Street No Street name
City
Postal code
Last name at birth (if different from last name above)
Have you been a Canadian citizen for the last 12 months?
Yes
If no, you must complete and attach Schedule RC66SCH, Status in Canada/Statement of Income, to your application.
First name and initial
. . . . . . . . . . . . . . . . . . . . . . . . . . .
English
R.R.
Part 1 – Information about the applicant
(Check only one box)
Language of correspondence
No
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Female
Male
See page 2 of the attached information sheet for the definitions.
(Vous pouvez obtenir ce formulaire en français à www.arc.gc.ca ou au 1-800-959-3376.)
RC66 E (08)
CANADA CHILD BENEFITS APPLICATION
To apply for all child benefit programs, complete this application and send it, along with any
other required documents, to one of our tax centres listed on the attached information sheet.
Enter the date your current marital status began. (If you checked box 2 or 5,
see the definitions for common-law partner and separated on page 2 of
the attached information sheet to determine the date you must enter)
Day
Do not use this area
When both a male and female parent reside in the same home, we usually consider the female parent to be the applicant.
You must also complete and attach schedule RC66SCH, Status in Canada/Statement of Income, if you or your
spouse or common-law partner:
became a new resident or returned as a resident of Canada in the last 2 years; or
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Complete the parts that apply to you (please print).
If yes, see page 1 of the attached information sheet to find out which documents you need to attach.
. . . . . . . .
Does your application include a period that started more than 11 months ago?
Yes
No
are, as defined in the Immigration and Refugee Protection Act, a permanent resident, protected person (refugee), or temporary
resident who has lived in Canada for the previous 18 months.
Home
02
6
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Privacy Act Personal Information Bank number CRA/P-PU-140
Printed in Canada
Part 5 – Certification
I certify that the information given on this form and in any documents attached, is correct.
Applicant's signature
Date
It is a serious offence to make a false statement.
Spouse's or common-law partner's signature
Date
It is a serious offence to make a false statement.
Name of child(ren)
Name, address, and telephone number
of previous caregiver or agency
MonthYear
Day
Province or territory (or country, if outside Canada)
If no, when did you become primarily responsible for the child?
MonthYear
Day
Have you been primarily responsible for this child since birth?
(see the definition on page 2 of the attached information sheet)
MonthYear
Day
Female
Male
Last name
Place of birth: City
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes No
First name and initial
. . . . . . . . . . . . . .
If you are applying for more than two children, use a separate sheet of paper to give the information requested
above for the additional child(ren). Sign the sheet, and attach it to this form.
Date of birth
Date of birth
MonthYear
Day
Last name
Last name at birth (if different from last name above)
Part 2 – Information about your spouse or common-law partner
Has your spouse or common-law partner been a Canadian citizen for
the last 12 months?
Yes
No
If no, you must complete and attach schedule RC66SCH, Status in Canada/Statement of Income, to your application.
Female
Male
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date the child(ren) left the
previous recipient's care
Child information
(Do not include children for whom you have already applied.)
Child information
(Do not include children for whom you have already applied.)
Part 3 – Information about the child(ren)
Does the child(ren) listed below reside with you all of the time?
If no, see "Shared eligibility" on page 2 of the attached information sheet.
Part 4 – Change of recipient
If your spouse's or common-law partner's address is different from your address, please
explain:
Social insurance number
First name and initial
. . . . . . . . . . . . . . . . . . . . . . . .
No
Yes
Province or territory (or country, if outside Canada)
If no, when did you become primarily responsible for the child?
MonthYear
Day
Have you been primarily responsible for this child since birth?
(see the definition on page 2 of the attached information sheet)
MonthYear
Day
Female
Male
Last name
Place of birth: City
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes No
First name and initial
. . . . . . . . . . . . . .
Date of birth
To find out if you need to attach proof of birth, see page 1 of the attached information sheet.
Complete this part if the child(ren) had been living with another individual or maintained by an agency.
