April 25, 2019

Canada Visa Application Centre

VFS Services Philippines Pvt. Inc.
Mezzanine Floor Ecoplaza Bldg.
Chino Roces Ave Ext.
Makati City 1231
Philippines

RE: Applicant
MYRNA DURANA KEITH
Birthdate: Nov. 4, 1971
Passport Number: P6196313A
LMIA # 8429095

To Whom It May Concern:

This package includes the following information required from employer:

1. IMM 5917 E page 6: Supplementary Information Form For Employer

2. Recent letters of employment for employer and spouse indicating salary
and hours of work
3. Letter from employer clearly explaining the need for care, the persons to
be cared for, how care needs are currently met, supported by
documentary evidence.
4. Notices of Assessment for the last 3 years for employer and spouse,
including the most recent tax year

I hope the information included in this package will suffice all requirements.
Should you have any questions, please contact me at your earliest convenience.

Sincerely,

Aubrey Delima
922 East 40th Avenue
Vancouver, BC V5W 1M3
Canada

CRA Business #862818721

April 25, 2019

Aubrey & Greg Delima

922 East 40th Avenue
LMIA # 8429095

Myrna Durana Keith

Birthdate: 1971-NOV-04
Passport Number P6196313A

Canadian Embassy
Citizenship & Immigration
Philippines

To Whom It May Concern:

Please accept this letter as our official offer of employment.

We require an In Home Caregiver to care for our family. My husband and I both work
and require a caregiver to help us while we are working. We have 2 children, ages 12 &
9. The job duties will include basic care for the children including preparing meals,
escorting them to and from school and activities, play and interaction. Light
housekeeping and laundry for the family as time permits is also a part of the job.

The position is 40 hours per week

Salary offered: $14.50/hour

Currently I have had to work only part time to take care of our children but I must work
full-time. With both of us working full-time hours we will require a caregiver for our
children.

Please find attached any supporting documents pertaining to our care.

Thank you,

Aubrey Delima
April 25, 2019

Canada Visa Application Centre

VFS Services Philippines Pvt. Inc.
29th Floor The World Center Bldg
330 Sen. Gil Puyat Avenue, Makati City
Philippines

To Whom It May Concern:

Please accept this letter as confirmation that Aubrey Delima is employed as an

Insurance Broker with A. Que Financial Services Ltd. since June 2013. She earns
commission income as she is self-employed. Her income is dependent on how much
insurance products she sells.

Aubrey has had to juggle her hours to accommodate her children’s schedule. As such,
the shorter hours at the office mean less production sales for Aubrey. I support her
request for an in-home Caregiver, as she has too much obligations at home that can be
alleviated by a full-time caregiver.

If you have any questions, please feel free to contact me.

Sincerely,

Amelia M. Que, B.A. Econ/AGA

Cell# (604) 879-7269
___________________________________________________________________________________

#207 – 4381 Fraser St.

Vancouver, BC V5V 4G4
Office: (604) 879-7289
Fax: (604) 879-7295
Website: www.aquefinancial.com
April 26, 2019

To Whom It May Concern:

This letter will confirm employment for Greg Delima.

Greg was hired by Arjo Canada Inc. on November 17, 2003 and is a fulltime employee.
Greg currently holds the position of Fleet Processing and Repair Specialist in our Rental
Operations department. He is currently receiving a yearly income of $51,398.78.

If you have any questions, please feel free to contact me at the coordinates below.

Regards,

Allan McIntyre
Human Resources Business Partner
Arjo Canada Inc.
Phone: 905-238-7880 ext. 585
Email: allan.mcintyre@arjo.com

Arjo Canada Inc. Phone: 1-800-665-8431 Page 1 of 1

90 Matheson Blvd W, Email: info@arjo.com
Suite 350
Mississauga, ON, L5R www.arjo.com
3R3
Canada
 AUBREY DELIMA

x Note: *her spouse is my 2nd cousin

300 - 13805 104th Ave

Cowley and Company 604-583-3000
Surrey, BC V3T 1W7

Janice Briones cousin 21/06/1981 04/04/2003 29/07/2005 contract finished

Mary Ann Ramos no blood 03/09/1975 22/01/2007 25/06/2010 contract finished

3 Jermaine Catua cousin 01/02/1979 06/03/2012 26/06/2015 contract finished
4 Michelle Fuentes no blood 12/12/1984 23/05/2017 17/05/2019 returning to Philippines May 18, 2019

April 25, 2019

Proof of income statement - My Account Page 1 of 3

Canada Revenue Agency

2018 Assessment
April 24, 2019

AUBREY DELIMA
922 40TH AVE E
VANCOUVER
BC V5W 1M3

Tax year: 2018 Social insurance number: 726 380 348

Taxing province: BC Province of residence: BC
Filing date: 23 APR 2019 Date of birth: 23 NOV 1975
Date of assessment: 02 MAY 2019 Marital status: MARRIED

Total income

Line Description Amount

121 Interest and other investment income $2,090
166 Gross commission income $132,969
139 Net commission income $80,059
150 Total income $82,149

Net income
Line Description Amount
208 RRSP deduction $5,000
222 Deduction for CPP or QPP contributions on self-employment and other earnings $2,593.80
233 Total deductions $7,593
234 Net income before adjustments $74,556
236 Net income $74,556

Taxable income
Line Description Amount
260 Taxable income $74,556
Proof of income statement - My Account Page 2 of 3

Refund or Balance owing

Line Description Amount
420 Net federal tax $7,448.00
421 CPP contributions payable on self-employment and other earnings (from Schedule 8) $5,187.60
428 Provincial or territorial tax $2,937.49
435 Total payable $15,573.09
476 Tax paid by instalments -$9,566.00
-- Balance before penalty and interest $6,007.09
-- Balance from this assessment $6,007.09
-- Final balance $6,007.09

Federal Tax - Schedule 1

Federal non-refundable tax credits

Line Description Amount
300 Basic personal amount - federal $11,809
307 Canada caregiver amount for other infirm dependants age 18 or older $6,986
-- CPP or QPP contributions allowed through employment $0.00
310 CPP or QPP contributions on self-employment and other earnings (from Schedule 8) $2,593.80
318 Disability amount transferred from a dependant - federal $8,235
335 Non-refundable tax credits (excluding donations) $29,623
338 Net non-refundable tax credits $4,443
349 Donations and gifts $828
350 Total federal non-refundable tax credits $5,272

Net federal tax

Line Description Amount
429 Basic federal tax $7,448.00

Amounts for Spouse or Common-law Partner and Dependants - Schedule 5

Line Description Amount
5112 Number of dependants for whom you are claiming the family caregiver amount for line 315 1

RRSP Unused Contributions, Transfers, and HBP or LLP Activities - Schedule 7

Line Description Amount
245 Total contributions made to your RRSP or your spouse or common-law partner's RRSP $5,000

CPP Contributions on Self-Employment and Other Earnings - Schedule 8

Line Description Amount
Pensionable net self-employment earnings (amounts from line 122 and lines 135 to 143 of
371 your return) $80,059
Proof of income statement - My Account Page 3 of 3

Donations and Gifts - Schedule 9

Line Description Amount
340 Allowable charitable donations and government gifts $2,955

Federal Tuition, Education and Textbook Amounts - Schedule 11

Line Description Amount
Education and textbook amounts according to number of months from column B of Forms
345 T2202, T2202A, TL11A, and TL11C - Disabled $0

British Columbia Tax - BC428

Non-refundable tax credits

Line Description Amount
5804 Basic personal amount - provincial/territorial $10,412
BC caregiver amount for infirm spouse or common-law partner and dependants age 18 or
5817 older $4,556
Canada Pension Plan or Quebec Pension Plan contributions on self-employment and other
5828 earnings (amount from line 310 of your federal Schedule 1) $2,593.80
5848 Disability amount transferred from a dependant - provincial/territorial $7,809
5880 Non-refundable tax credits (excluding donations) $25,370
5884 Net non-refundable tax credits $1,283
5896 Donations and gifts $472
6150 Provincial or Territorial non-refundable tax credits $1,756

British Columbia tax

Line Description Amount
-- Basic provincial or territorial tax $2,937.76
Proof of income statement - My Account Page 1 of 3

Canada Revenue Agency

2017 Assessment
April 16, 2019

AUBREY DELIMA
922 40TH AVE E
VANCOUVER
BC V5W 1M3

Tax year: 2017 Social insurance number: 726 380 348

Taxing province: BC Province of residence: BC
Filing date: 29 APR 2018 Date of birth: 23 NOV 1975
Date of assessment: 07 MAY 2018 Marital status: MARRIED

Residency information for tax administration agreements

Line Description Amount

Did you reside within the Nisga'a Lands on December 31 of the year you are viewing? Enter
5084 '1', otherwise, enter '2'. 2
5082 If yes, are you a citizen of the Nisga'a Nation? Enter '1', otherwise, enter '2'. 2

Total income
Line Description Amount
121 Interest and other investment income $965
162 Gross business income $103,643
135 Net business income $58,175
150 Total income $59,140

Net income
Line Description Amount
208 RRSP deduction $4,000
222 Deduction for CPP or QPP contributions on self-employment and other earnings $2,564.10
233 Total deductions $6,564
234 Net income before adjustments $52,576
236 Net income $52,576

Taxable income
Line Description Amount
260 Taxable income $52,576
Proof of income statement - My Account Page 2 of 3

Refund or Balance owing

Line Description Amount
420 Net federal tax $3,075.21
421 CPP contributions payable on self-employment and other earnings (from Schedule 8) $5,128.20
428 Provincial or territorial tax $1,361.99
435 Total payable $9,565.40
-- Balance before penalty and interest $9,565.40
-- Interest $11.01
-- Balance from this assessment $9,576.41
-- Final balance $9,576.41

Federal Tax - Schedule 1

Federal non-refundable tax credits

Line Description Amount
300 Basic personal amount - federal $11,635
307 Canada caregiver amount for other infirm dependants age 18 or older $6,883
-- CPP or QPP contributions allowed through employment $0.00
310 CPP or QPP contributions on self-employment and other earnings (from Schedule 8) $2,564.10
318 Disability amount transferred from a dependant - federal $8,113
335 Non-refundable tax credits (excluding donations) $29,195
338 Net non-refundable tax credits $4,379
349 Donations and gifts $798
350 Total federal non-refundable tax credits $5,177

Net federal tax

Line Description Amount
429 Basic federal tax $3,075.21

Amounts for Spouse or Common-law Partner and Dependants - Schedule 5

Line Description Amount
5112 Number of dependants for whom you are claiming the family caregiver amount for line 315 1

RRSP Unused Contributions, Transfers, and HBP or LLP Activities - Schedule 7

Line Description Amount
245 Total contributions made to your RRSP or your spouse or common-law partner's RRSP $4,000

CPP Contributions on Self-Employment and Other Earnings - Schedule 8

Line Description Amount
Pensionable net self-employment earnings (amounts from line 122 and lines 135 to 143 of
371 your return) $58,175
Proof of income statement - My Account Page 3 of 3

Donations and Gifts - Schedule 9

Line Description Amount
340 Allowable charitable donations and government gifts $2,849

Federal Tuition, Education and Textbook Amounts - Schedule 11

Line Description Amount
Education and textbook amounts according to number of months from column B of Forms
345 T2202, T2202A, TL11A, and TL11C - Disabled $0

British Columbia Tax - BC428

Non-refundable tax credits

Line Description Amount
5804 Basic personal amount - provincial/territorial $10,208
Canada Pension Plan or Quebec Pension Plan contributions on self-employment and other
5828 earnings (amount from line 310 of your federal Schedule 1) $2,564.10
5840 Caregiver amount - provincial/territorial $4,467
5848 Disability amount transferred from a dependant - provincial/territorial $7,656
5880 Non-refundable tax credits (excluding donations) $24,895
5884 Net non-refundable tax credits $1,259
5896 Donations and gifts $399
6150 Provincial or Territorial non-refundable tax credits $1,659

British Columbia tax

Line Description Amount
-- Basic provincial or territorial tax $1,362.20
Proof of income statement - My Account Page 1 of 4

Canada Revenue Agency

2016 Assessment
April 16, 2019

AUBREY DELIMA
922 40TH AVE E
VANCOUVER
BC V5W 1M3

Tax year: 2016 Social insurance number: 726 380 348

Taxing province: BC Province of residence: BC
Filing date: 26 APR 2017 Date of birth: 23 NOV 1975
Date of assessment: 04 MAY 2017 Marital status: MARRIED

Residency information for tax administration agreements

Line Description Amount

Did you reside within the Nisga'a Lands on December 31 of the year you are viewing? Enter
5084 '1', otherwise, enter '2'. 2
5082 If yes, are you a citizen of the Nisga'a Nation? Enter '1', otherwise, enter '2'. 2

Total income
Line Description Amount
101 Employment Income (box 14 on all T4 slips) $10,286
117 Universal child care benefit $1,180
162 Gross business income $73,764
135 Net business income $30,381
150 Total income $41,847

Net income
Line Description Amount
206 Pension adjustment (box 52 on all T4 slips and box 34 on all T4A slips) $536
207 Registered pension plan deduction (box 20 on all T4 slips and box 32 on all T4A slips) $732
212 Annual union, professional, or like dues (box 44 on all T4 slips and receipts) $178
214 Child care expenses $11,847
222 Deduction for CPP or QPP contributions on self-employment and other earnings $1,390.60
233 Total deductions $14,147
234 Net income before adjustments $27,700
236 Net income $27,700
Proof of income statement - My Account Page 2 of 4

Taxable income
Line Description Amount
260 Taxable income $27,700

Refund or Balance owing

Line Description Amount
420 Net federal tax $1,543.35
421 CPP contributions payable on self-employment and other earnings (from Schedule 8) $2,781.20
428 Provincial or territorial tax $450.91
435 Total payable $4,775.46
437 Total income tax deducted (from all information slips) $909.40
-- Balance before penalty and interest $3,866.06
-- Interest $2.12
-- Balance from this assessment $3,868.18
-- Final balance $3,868.18

Federal Tax - Schedule 1

Federal non-refundable tax credits

Line Description Amount
300 Basic personal amount - federal $11,474
308 CPP or QPP contributions through employment (box 16 and 17 on all T4 slips) $449.20
-- CPP or QPP contributions allowed through employment $449.20
310 CPP or QPP contributions on self-employment and other earnings (from Schedule 8) $1,390.60
312 Employment Insurance premiums (box 18 of all T4 slips) $181.02
-- Employment Insurance premiums allowed $181.02
363 Canada employment amount $1,161
323 Tuition, education, and textbook amounts $125
335 Non-refundable tax credits (excluding donations) $14,780
338 Net non-refundable tax credits $2,217
349 Donations and gifts $393
350 Total federal non-refundable tax credits $2,611

Net federal tax

Line Description Amount
429 Basic federal tax $1,543.35

Capital Gains (or Losses) - Schedule 3

Line Description Amount
181 Year of acquisition 0
Proof of income statement - My Account Page 3 of 4

CPP Contributions on Self-Employment and Other Earnings - Schedule 8

Line Description Amount
5549 CPP pensionable earnings $10,286
5034 CPP contributions $449.20
Pensionable net self-employment earnings (amounts from line 122 and lines 135 to 143 of
371 your return) $30,381

Donations and Gifts - Schedule 9

Line Description Amount
340 Allowable charitable donations and government gifts $1,455

Federal Tuition, Education and Textbook Amounts - Schedule 11

Line Description Amount
320 Eligible tuition fees paid $125

Employment Insurance Premiums on Self-Employment and Other Eligible Earnings - Schedule 13

Line Description Amount
EI insurable earnings in accordance with box 24 of all your T4 slips (if any of the amounts in
box 24 have been left blank, are indicated as nil, or 0 and you are not EI exempt, in the
5478 calculation, for that T4, please use the amounts from box 14) $10,286

British Columbia Tax - BC428

Non-refundable tax credits

Line Description Amount
5804 Basic personal amount - provincial/territorial $10,027
Canada Pension Plan or Quebec Pension Plan contributions through employment (amount
5824 from line 308 of your federal Schedule 1) $449.20
Canada Pension Plan or Quebec Pension Plan contributions on self-employment and other
5828 earnings (amount from line 310 of your federal Schedule 1) $1,390.60
5832 Employment Insurance premiums (amount from line 312 of your federal Schedule 1) $181.02
5856 Tuition and education amounts (provincial/territorial Schedule (S11)) $125
5880 Non-refundable tax credits (excluding donations) $12,172
5884 Net non-refundable tax credits $615
5896 Donations and gifts $194
6150 Provincial or Territorial non-refundable tax credits $810

British Columbia tax

Line Description Amount
-- Basic provincial or territorial tax $591.62
Proof of income statement - My Account Page 4 of 4

Provincial/Territorial Tuition and Education Amounts - Schedule S11

Line Description Amount
5914 Eligible tuition fees paid $125.00

Additional information
Line Description Amount
CPP pensionable earnings in accordance with box 26 of all your T4 slips (if any of the amounts
in box 26 have been left blank, are indicated as nil, or 0 and you are not CPP exempt, in the
5554 calculation, for that T4, please use the amounts from box 14) $10,286
6794 Child care expenses for children 6 or under $5,000
6795 Total Child Care Expenses $11,847
Amount calculated in Part B of form T778 for eligible children for whom the disability amount
6796 can be claimed $11,000
Proof of income statement - My Account Page 1 of 3

Canada Revenue Agency

2018 Assessment
April 16, 2019

GREG DELIMA
922 40TH AVE E
VANCOUVER
BC V5W 1M3

Tax year: 2018 Social insurance number: 726 492 598

Taxing province: BC Province of residence: BC
Filing date: 11 MAR 2019 Date of birth: 28 DEC 1974
Date of assessment: 21 MAR 2019 Marital status: MARRIED

Total income

Line Description Amount

101 Employment Income (box 14 on all T4 slips) $54,349
144 Workers' compensation benefits (box 10 on the T5007 slip) $1,506
150 Total income $55,855

Net income
Line Description Amount
206 Pension adjustment (box 52 on all T4 slips and box 34 on all T4A slips) $6,333
207 Registered pension plan deduction (box 20 on all T4 slips and box 32 on all T4A slips) $3,247
214 Child care expenses $21,000
233 Total deductions $24,247
234 Net income before adjustments $31,608
236 Net income $31,608

Taxable income
Line Description Amount
250 Other payments deduction $1,506
260 Taxable income $30,102
Proof of income statement - My Account Page 2 of 3

Refund or Balance owing

Line Description Amount
420 Net federal tax $2,058.21
428 Provincial or territorial tax $780.86
435 Total payable $2,839.07
437 Total income tax deducted (from all information slips) $7,860.61
-- Balance before penalty and interest -$5,021.54
-- Balance from this assessment -$5,021.54
-- Final balance -$5,021.54

Federal Tax - Schedule 1

Federal non-refundable tax credits

Line Description Amount
300 Basic personal amount - federal $11,809
308 CPP or QPP contributions through employment (box 16 and 17 on all T4 slips) $2,517.05
-- CPP or QPP contributions allowed through employment $2,517.05
312 Employment Insurance premiums (box 18 of all T4 slips) $858.22
-- Employment Insurance premiums allowed $858.22
363 Canada employment amount $1,195
335 Non-refundable tax credits (excluding donations) $16,379
338 Net non-refundable tax credits $2,456
350 Total federal non-refundable tax credits $2,456

Net federal tax

Line Description Amount
429 Basic federal tax $2,058.21

CPP Contributions on Self-Employment and Other Earnings - Schedule 8

Line Description Amount
5549 CPP pensionable earnings $54,349
5034 CPP contributions $2,517.05

Federal Tuition, Education and Textbook Amounts - Schedule 11

Line Description Amount
Education and textbook amounts according to number of months from column B of Forms
345 T2202, T2202A, TL11A, and TL11C - Disabled $0

Employment Insurance Premiums on Self-Employment and Other Eligible Earnings - Schedule 13

Line Description Amount
EI insurable earnings in accordance with box 24 of all your T4 slips (if any of the amounts in
box 24 have been left blank, are indicated as nil, or 0 and you are not EI exempt, in the
5478 calculation, for that T4, please use the amounts from box 14) $51,700
Proof of income statement - My Account Page 3 of 3

British Columbia Tax - BC428

Non-refundable tax credits

Line Description Amount
5804 Basic personal amount - provincial/territorial $10,412
Canada Pension Plan or Quebec Pension Plan contributions through employment (amount
5824 from line 308 of your federal Schedule 1) $2,517.05
5832 Employment Insurance premiums (amount from line 312 of your federal Schedule 1) $858.22
5880 Non-refundable tax credits (excluding donations) $13,787
5884 Net non-refundable tax credits $697
6150 Provincial or Territorial non-refundable tax credits $697

British Columbia tax

Line Description Amount
-- Basic provincial or territorial tax $826.16

Additional information
Line Description Amount
CPP pensionable earnings in accordance with box 26 of all your T4 slips (if any of the amounts
in box 26 have been left blank, are indicated as nil, or 0 and you are not CPP exempt, in the
5554 calculation, for that T4, please use the amounts from box 14) $54,349
6795 Total Child Care Expenses $36,400
Amount calculated in Part B of form T778 for eligible children for whom the disability amount
6796 can be claimed $11,000
Proof of income statement - My Account Page 1 of 3

Canada Revenue Agency

2016 Assessment
April 16, 2019

GREG DELIMA
922 40TH AVE E
VANCOUVER
BC V5W 1M3

Tax year: 2016 Social insurance number: 726 492 598

Taxing province: BC Province of residence: BC
Filing date: 26 APR 2017 Date of birth: 28 DEC 1974
Date of assessment: 04 MAY 2017 Marital status: MARRIED

Residency information for tax administration agreements

Line Description Amount

Did you reside within the Nisga'a Lands on December 31 of the year you are viewing? Enter
5084 '1', otherwise, enter '2'. 2
5082 If yes, are you a citizen of the Nisga'a Nation? Enter '1', otherwise, enter '2'. 2

Total income
Line Description Amount
101 Employment Income (box 14 on all T4 slips) $47,351
150 Total income $47,351

Net income
Line Description Amount
206 Pension adjustment (box 52 on all T4 slips and box 34 on all T4A slips) $4,153
207 Registered pension plan deduction (box 20 on all T4 slips and box 32 on all T4A slips) $1,692
233 Total deductions $1,692
234 Net income before adjustments $45,659
236 Net income $45,659

Taxable income
Line Description Amount
260 Taxable income $45,659
Proof of income statement - My Account Page 2 of 3

Refund or Balance owing

Line Description Amount
420 Net federal tax $2,274.38
428 Provincial or territorial tax $1,189.94
435 Total payable $3,464.32
437 Total income tax deducted (from all information slips) $6,579.81
458 Children's Fitness Amount $253
459 Refundable Children's Fitness Tax Credit $37.95
-- Balance before penalty and interest -$3,153.44
-- Balance from this assessment -$3,153.44
-- Final balance -$3,153.44

Federal Tax - Schedule 1

Federal non-refundable tax credits

Line Description Amount
300 Basic personal amount - federal $11,474
306 Amount for infirm dependants age 18 or older - federal $6,788
308 CPP or QPP contributions through employment (box 16 and 17 on all T4 slips) $2,170.65
-- CPP or QPP contributions allowed through employment $2,170.65
312 Employment Insurance premiums (box 18 of all T4 slips) $886.61
-- Employment Insurance premiums allowed $886.61
363 Canada employment amount $1,161
370 Children's arts amount $150
318 Disability amount transferred from a dependant - federal $8,001
335 Non-refundable tax credits (excluding donations) $30,631
338 Net non-refundable tax credits $4,594
350 Total federal non-refundable tax credits $4,594

Net federal tax

Line Description Amount
429 Basic federal tax $2,274.38

Capital Gains (or Losses) - Schedule 3

Line Description Amount
181 Year of acquisition 0

CPP Contributions on Self-Employment and Other Earnings - Schedule 8

Line Description Amount
5549 CPP pensionable earnings $47,351
5034 CPP contributions $2,170.65
Proof of income statement - My Account Page 3 of 3

Employment Insurance Premiums on Self-Employment and Other Eligible Earnings - Schedule 13

Line Description Amount
EI insurable earnings in accordance with box 24 of all your T4 slips (if any of the amounts in
box 24 have been left blank, are indicated as nil, or 0 and you are not EI exempt, in the
5478 calculation, for that T4, please use the amounts from box 14) $47,351

British Columbia Tax - BC428

Non-refundable tax credits

Line Description Amount
5804 Basic personal amount - provincial/territorial $10,027
5820 Amount for infirm dependants age 18 or older - provincial/territorial $4,388
Canada Pension Plan or Quebec Pension Plan contributions through employment (amount
5824 from line 308 of your federal Schedule 1) $2,170.65
5832 Employment Insurance premiums (amount from line 312 of your federal Schedule 1) $886.61
5838 Children's fitness amount $253
5842 Children's fitness equipment amount $126
5841 Children's arts amount $150
5846 Back-to-school amount $500
5848 Disability amount transferred from a dependant - provincial/territorial $7,521
5880 Non-refundable tax credits (excluding donations) $26,023
5884 Net non-refundable tax credits $1,316
6150 Provincial or Territorial non-refundable tax credits $1,316

British Columbia tax

Line Description Amount
-- Basic provincial or territorial tax $1,190.57

Additional information
Line Description Amount
5107 Universal Child Care Benefit reported by the lower income spouse or common-law partner $1,180
CPP pensionable earnings in accordance with box 26 of all your T4 slips (if any of the amounts
in box 26 have been left blank, are indicated as nil, or 0 and you are not CPP exempt, in the
5554 calculation, for that T4, please use the amounts from box 14) $47,351
Proof of income statement - My Account Page 1 of 3

Canada Revenue Agency

2017 Assessment
April 16, 2019

GREG DELIMA
922 40TH AVE E
VANCOUVER
BC V5W 1M3

Tax year: 2017 Social insurance number: 726 492 598

Taxing province: BC Province of residence: BC
Filing date: 30 APR 2018 Date of birth: 28 DEC 1974
Date of assessment: 10 MAY 2018 Marital status: MARRIED

Residency information for tax administration agreements

Line Description Amount

Did you reside within the Nisga'a Lands on December 31 of the year you are viewing? Enter
5084 '1', otherwise, enter '2'. 2
5082 If yes, are you a citizen of the Nisga'a Nation? Enter '1', otherwise, enter '2'. 2

Total income
Line Description Amount
101 Employment Income (box 14 on all T4 slips) $47,199
150 Total income $47,199

Net income
Line Description Amount
206 Pension adjustment (box 52 on all T4 slips and box 34 on all T4A slips) $5,498
207 Registered pension plan deduction (box 20 on all T4 slips and box 32 on all T4A slips) $2,819
214 Child care expenses $21,000
233 Total deductions $23,819
234 Net income before adjustments $23,380
236 Net income $23,380

Taxable income
Line Description Amount
260 Taxable income $23,380
Proof of income statement - My Account Page 2 of 3

Refund or Balance owing

Line Description Amount
420 Net federal tax $1,145.16
428 Provincial or territorial tax $204.13
435 Total payable $1,349.29
437 Total income tax deducted (from all information slips) $6,161.58
-- Balance before penalty and interest -$4,812.29
-- Balance from this assessment -$4,812.29
-- Final balance -$4,812.29

Federal Tax - Schedule 1

Federal non-refundable tax credits

Line Description Amount
300 Basic personal amount - federal $11,635
308 CPP or QPP contributions through employment (box 16 and 17 on all T4 slips) $2,163.10
-- CPP or QPP contributions allowed through employment $2,163.10
312 Employment Insurance premiums (box 18 of all T4 slips) $765.91
-- Employment Insurance premiums allowed $765.91
363 Canada employment amount $1,178
335 Non-refundable tax credits (excluding donations) $15,742
338 Net non-refundable tax credits $2,361
350 Total federal non-refundable tax credits $2,361

Net federal tax

Line Description Amount
429 Basic federal tax $1,145.16

CPP Contributions on Self-Employment and Other Earnings - Schedule 8

Line Description Amount
5549 CPP pensionable earnings $47,199
5034 CPP contributions $2,163.10

Federal Tuition, Education and Textbook Amounts - Schedule 11

Line Description Amount
Education and textbook amounts according to number of months from column B of Forms
345 T2202, T2202A, TL11A, and TL11C - Disabled $0

Employment Insurance Premiums on Self-Employment and Other Eligible Earnings - Schedule 13

Line Description Amount
EI insurable earnings in accordance with box 24 of all your T4 slips (if any of the amounts in
box 24 have been left blank, are indicated as nil, or 0 and you are not EI exempt, in the
5478 calculation, for that T4, please use the amounts from box 14) $47,199
Proof of income statement - My Account Page 3 of 3

British Columbia Tax - BC428

Non-refundable tax credits

Line Description Amount
5804 Basic personal amount - provincial/territorial $10,208
Canada Pension Plan or Quebec Pension Plan contributions through employment (amount
5824 from line 308 of your federal Schedule 1) $2,163.10
5832 Employment Insurance premiums (amount from line 312 of your federal Schedule 1) $765.91
5880 Non-refundable tax credits (excluding donations) $13,137
5884 Net non-refundable tax credits $664
6150 Provincial or Territorial non-refundable tax credits $664

British Columbia tax

Line Description Amount
-- Basic provincial or territorial tax $519.02

Additional information
Line Description Amount
CPP pensionable earnings in accordance with box 26 of all your T4 slips (if any of the amounts
in box 26 have been left blank, are indicated as nil, or 0 and you are not CPP exempt, in the
5554 calculation, for that T4, please use the amounts from box 14) $47,199
6795 Total Child Care Expenses $21,367
Amount calculated in Part B of form T778 for eligible children for whom the disability amount
6796 can be claimed $11,000