Lazrev, Yevgeni SIN: *** **7 929 Printed: 2021/02/13 12:19

Canada Revenue Agence du revenu Information Return for Electronic Filing of Protected B
Agency du Canada
an Individual's Income Tax and Benefit Return when completed
Tax Year : 2020
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 on page 2. The individual identified in Part A
(or the individual's legal representative) must sign Part F. Your electronic filer must fill out Part C and Part D before submitting your return. 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 (mandatory)
First name Last name Social insurance number
Yevgeni Lazrev *** **7 929
Mailing address: Apt number - Street number - Street name PO Box RR City Prov./Terr Postal code
1109-801 Mount Pleasant Rd Toronto ON M4P 2Z4
Get your CRA mail electronically delivered in My Account (optional)
Email Address:
By giving an email address, I am registering to receive email notifications from the CRA and agreeing to the terms of use on page 2.
Part B - Declaration of amounts from your Income Tax and Benefit Return (mandatory)
Enter the following amounts from your return, if applicable:
Total income (line 15000) 13,747 45
Taxable income (line 26000) 8,419 56 Refund (line 48400) 300 00
or
Total federal non-refundable tax credits (line 35000) 3,270 75 Balance owing (line 48500)
Part C - Electronic filer identification (mandatory)
By signing Part F below, I declare that the following person or firm is electronically filing the new or the amended Income Tax and Benefit Return of the person named in Part A. Part F
must be signed before the return is electronically transmitted.

Name of person or firm : GTA Tax Corp. Electronic filer number : J7620
Part D - Document Control number (mandatory)
The document control number generated for my electronic record:
J76202013VQK4
Part E - Delivery of your notices of assessment and reassessment (a selection must be made)
How do you want to receive your notices of assessment and reassessment?
Select one or more of the following electronic options:
I am registering (as indicated in Part A above) or I am already registered to receive email notifications from the CRA and can view and access my notices of assessment and
reassessment online.
I would like my electronic filer to receive a one time notice of assessment and reassessment electronically in their software and provide me with a copy.
I understand that by checking (x) this box, I am allowing the CRA to electronically provide my assessment results and my notices of assessment and reassessment to the electronic filer
(including a discounter) named in Part C. I will now receive a copy of my notices of assessment and reassessment from my electronic filer. For more information, see the Express NOA
section on page 2.
OR
X I would like to receive paper notices of assessment and reassessment through Canada Post.
I will receive my notices of assessment and reassessment through Canada Post once my return or amended return has been assessed. If I have already registered to receive email
notifications from the CRA and I tick this box, I understand that I will not receive a copy of my notice through Canada Post.

Part F - Declaration and authorization (mandatory)

I declare that the information entered in Parts A, B and C is correct and complete and fully discloses my income from all sources. I also declare that I have read the information
on page 2, and that the electronic filer identified in Part C is filing my return. I allow this electronic filer to communicate with the CRA to correct any errors or
omissions.
2021/02/13
Signature (individual identified in Part A or legal representative) Name and title of legal representative Year Month Day
00:00:00
HH MM SS
Privacy Act, personal information bank number CRA PPU 211

T183 E (20) (Ce formulaire est disponible en français)

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