Protected B

when completed

Canada Child Benefit Application

includes federal, provincial, and territorial programs

Find out if this form is for you

Fill out this form to apply for the Canada child benefit (CCB). The information you provide on this application will also be used to determine your eligibility for the
goods and services tax/harmonized sales tax (GST/HST) credit, the Canada Carbon Rebate (CCR – formerly known as the climate action incentive), and related
federal, provincial, or territorial programs the Canada Revenue Agency (CRA) administers. You can also use this form if you started a shared-custody situation
for one or more children.
Do not fill out this form if you already applied using My Account on the CRA website or when you registered the birth of your newborn with your province or
territory (except Nunavut).

Who can fill out this form

Only the person who is primarily responsible for the care and upbringing of the child can apply by filling out this form (see "Primarily responsible for the care
and upbringing of the child" on page 3).
For CCB purposes, when a child resides with a female parent in the home, the female parent is usually considered to be primarily responsible for the child.
This is referred to as the female presumption, and is a legislative requirement under the Income Tax Act. However, if the child's other parent is primarily
responsible, they can apply. They must attach a signed letter from the female parent that states that the other parent with whom she resides is primarily
responsible for all the children in the household. If the child lives with same-sex parents, only one parent should apply for all the children in the home. No matter
which parent receives the CCB, the amount will be the same.

For more information

For more information on the CCB, including eligibility requirements, go to canada.ca/cra-benefits, read Booklet T4114, Canada Child Benefit, or
call 1-800-387-1193. If you reside in Yukon, North-West Territories, or Nunavut, call 1-866-426-1527. From outside Canada or the United States,
call 1-613-940-8495. The CRA accepts collect calls by automated response.

Step 1 – Your information

Social insurance number (SIN):
If you do not have a SIN, see Booklet T4114, Canada Child Benefit, under "How to apply."

First name:

Last name:

Date of birth:
Year Month Day

Your language of correspondence: English Français

Phone numbers: Home: Work: Ext: Cell:

Step 2 – Your address

Mailing address
Apt. No. – Street No., Street name, PO Box, RR:

City:

Province or territory (or country if outside Canada):

Postal or ZIP code:

Have you moved from a different province or

territory within the last 12 months? Yes No

If yes, enter the previous province or territory Date:

and the date you moved:
Year Month Day

Home address Same as mailing address

Apt. No. – Street No., Street name, RR:

City:

Province or territory (or country if outside Canada):

Postal or ZIP code:

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Step 3 – Your marital status

Select the box that applies to your current
Married – you are legally married to someone.
status (select only one box):

Living common-law – you are living in a conjugal relationship with someone to whom you are not
married and to whom at least one of the following situations applies. They:
• have been living with you for at least 12 continuous months. This includes any period you were
separated for less than 90 days because of a breakdown in your relationship
• are the parent of your child by birth or adoption
• have 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

Separated – you have been living apart from your spouse or common-law partner because of a
breakdown in the relationship for a period of at least 90 days and you have not reconciled.
Once you have been separated for 90 days, the effective day of your separation is the date you started
living apart.
You would still be considered to have a spouse or common-law partner if there is no breakdown in the
relationship and you were living apart for reasons such as work, studies, or health problems.
Note
Generally, you are not considered separated if your spouse or common-law partner is incarcerated or
does not live in Canada, as long as there is no breakdown in your relationship.

Divorced – you were married and are now legally divorced.

Widowed – your spouse or common-law partner is deceased.

Single – you are single and none of the above apply.

Enter the date the selected status began

(leave it blank if you have always been single):
Year Month Day

If you selected married or living common-law, enter your spouse or common-law partner's information:

Social insurance number (SIN):

If your spouse or common-law partner does not have a SIN, see Booklet T4114, Canada Child Benefit, under "How to apply."

First name:

Last name:

Date of birth:
Year Month Day
If your spouse or common-law partner's address is
different from yours, enter it here; otherwise,
their address will be updated to match the address
indicated in Step 2.

Your spouse or common-law partner is a non-resident of Canada

Step 4 – Your citizenship status

You become a Canadian citizen when you are born in Canada or are granted Canadian citizenship by Immigration, Refugees and Citizenship Canada.

Have you been a Canadian citizen for the last

12 months? Yes No

Has your spouse or common-law partner (if you

have one) been a Canadian citizen for the
last 12 months? Yes No

If you answered no to either of these questions, you have to fill out Form RC66SCH, Status in Canada and Income Information.

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 Protected B when completed

Step 5 – Newcomer or returning resident of Canada

Within the last two years, did you become a
newcomer to Canada or return after an absence Yes No
of at least six months?
Within the last two years, did your spouse or
common-law partner (if you have one) become a
newcomer to Canada or return after an absence Yes No
of at least six months?
If you answered yes to either of these questions, you have to fill out Form RC66SCH, Status in Canada and Income Information.

Step 6 – Information about the child(ren)

You may need to provide supporting documents for the child or children for whom you are completing this form. See "What to attach to this form" on page 5.

Primarily responsible for the care and upbringing of the child

Being primarily responsible for the care and upbringing of the 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, when the child lives with you.

Shared custody
This normally happens after a separation or a divorce. The CRA considers you to be in a shared-custody situation if the child lives with you 40% to 60% of the
time and the rest of the time with another individual at a different address.
For more information on shared custody, see Booklet T4114, Canada Child Benefit, under "If you share custody of a child."

Do not give information about a child for whom you have already applied, unless the child left your care and has now returned, or the percentage of time the
child is in your care has changed.

Child 1 – Information
First name:

Last name:

Gender: Female Male

Date of birth:
Year Month Day
City of birth:

Province or territory of birth

(or country if outside Canada):
You must be primarily responsible for the care and upbringing of this child when the child lives with you.

Does the child live with you more than 60% of the
time? Yes No

If yes, enter the date the child started living

with you more than 60% of the time. If the child or Since birth
has lived with you since birth, tick the box: Year Month Day

If no, select the box that represents the percentage of time the child lives with you (select only one box):

40% to 60% of the time, and the child lives the rest of the time with another individual at
a different address (for example, the child lives with you one week and with the other individual one
week, or with you 4 days a week and with the other individual 3 days a week)
If you select this box, the CRA considers you to be in a shared custody situation for this child. Enter the
date the child started living with you 40% to 60% of the time:

Year Month Day

Less than 40% of the time (for example, the child lives with you every second weekend)
If you select this box, you should not apply since the CRA does not consider you to be eligible for the
child and family benefits for this child.

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 Protected B when completed

Step 6 – Information about the child(ren) (continued)

Child 2 – Information
First name:

Last name:

Gender: Female Male

Date of birth:
Year Month Day

City of birth:

Province or territory of birth

(or country if outside Canada):
You must be primarily responsible for the care and upbringing of this child when the child lives with you.

Does the child live with you more than 60% of the
time? Yes No
If yes, enter the date the child started living
with you more than 60% of the time. If the child
has lived with you since birth, tick the box: or Since birth
Year Month Day

If no, select the box that represents the percentage of time the child lives with you (select only one box):

40% to 60% of the time, and the child lives the rest of the time with another individual at
a different address (for example, the child lives with you one week and with the other individual one
week, or with you 4 days a week and with the other individual 3 days a week)
If you select this box, the CRA considers you to be in a shared custody situation for this child. Enter the
date the child started living with you between 40% to 60% of the time:

Year Month Day

Less than 40% of the time (for example, the child lives with you every second weekend)
If you select this box, you should not apply since the CRA does not consider you to be eligible for the
child and family benefits for this child.
If you are applying for more than two children, you can use Form RC66-1, Additional Children. You can also attach a separate sheet of paper with the information
asked above.

Step 7 – Signature
I certify that the information given on this form and in any attached document is correct and complete. I understand that it is a serious offence to make a false
statement.

Your signature Date:

Year Month Day

If your marital status is married or living common-law, your spouse or common-law partner also needs to sign below. If your spouse or common-law partner is
living abroad, their signature is not required.

Spouse or common-law
partner's signature Date:
Year Month Day
Personal information (including the SIN) is collected and used to administer or enforce the Income Tax Act and related programs and activities including administering tax, benefits,
audit, compliance, and collection. The information collected may be disclosed to other federal, provincial, territorial, aboriginal, or foreign government institutions to the extent authorized
by law. Failure to provide this information may result in paying interest or penalties, or in other actions. Under the Privacy Act, individuals have a right of protection, access to and
correction of their personal information, and to file a complaint with the Privacy Commissioner of Canada regarding the handling of their personal information. Refer to Personal
Information Bank CRA PPU 063 on Info Source at canada.ca/cra-info-source.

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What to attach to this form
You only have to attach documents to your application if you are in any of the situations mentioned below. However, the CRA may ask you for photocopies of
certain documents at a later date.
If your documents are in a language other than English or French, you have to provide a copy of the original documents written in the foreign language with an
acceptable English or French translation. For more information, go to canada.ca/child-benefits-supporting-documents.
To get the CRA's forms and publications, go to canada.ca/cra-forms-publications or call 1-800-387-1193.

If you are in the following situation: You need to attach the following document(s) to your application:
You answered "no" to either of these questions in Step 4: Form RC66SCH, Status in Canada and Income Information
• Have you been a Canadian citizen for the last 12 months?
• Has your spouse or common-law partner (if you have one) been a
Canadian citizen for the last 12 months?
You answered "yes" to either of these questions in Step 5: Form RC66SCH, Status in Canada and Income Information
• Within the last two years, did you become a newcomer to Canada or return
after an absence of at least six months?
• Within the last two years, did your spouse or common-law partner (if you
have one) become a newcomer to Canada or return after an absence of at
least six months?

The CRA has not paid benefits to anyone for the child or children for whom you Proof of birth for the child (see the examples of acceptable documents
are completing this form below)

The child started living with you more than 11 months ago Clear photocopies (including both sides of all pages) of all of the following
documents for the entire period:
• proof of birth for each child. See the examples of acceptable
documents below
• proof that you resided in Canada (at least three documents). See the
examples of acceptable documents below
• proof that you were the person who is primarily responsible for the care
and upbringing of the child (at least three documents). See the
examples of acceptable documents on the next page
• proof of citizenship or immigration status in Canada for you and your
spouse or common-law partner (if you have one)
Form RC66-1, Additional Children, or attach a separate sheet of paper with
You are applying for more than two children
the information requested in Step 6

Examples of acceptable documents

As proof of birth, you have to provide a photocopy of one document with the child's first name, last name, and date of birth, such as:
• birth certificate or birth registration
• hospital record of birth or record of the physician, nurse, or midwife who attended the birth
• passport
• record of landing or confirmation of permanent residence issued by Immigration, Refugees and Citizenship Canada
• citizenship certificate
• notice of decision or a temporary resident's permit issued under the Immigration and Refugee Protection Act
• certificate of Indian status card
• provincial identity card

As proof that you resided in Canada, you have to provide a photocopy of at least three documents, such as:
• lease agreement
• rent receipt
• household bill (gas, electricity, cable television, telephone)
• driver's license, vehicle registration, or car insurance
• membership in social or professional organizations

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Examples of acceptable documents (continued)
As proof that you were the person who is primarily responsible for the care and upbringing of the child, you have to provide a photocopy of at least
three documents, such as:
• a letter from the daycare or school authorities indicating the child's home address and contact information on file
• a letter from a social worker, a band council, or a resettlement officer stating that they have personal knowledge that the child lived with you for the period
you indicated
• a registration form or a receipt from an activity or club the child was enrolled in for the period you indicated
• a court order, decree, or separation agreement that explains the type of custody arrangement you have (for example, shared custody) and clearly shows
the living arrangements for the child
• any other document showing that the child lived with you for the period you indicated

For a complete list of all supporting documents, go to canada.ca/child-benefits-supporting-documents.

Getting benefits and credits when in an abusive or violent relationship

At the CRA, we know that some situations can affect access to benefits and credits. We're committed to helping you get your payments, whatever your
circumstances.
If you have not applied for the CCB for a child under 18 years of age in your care, please apply. In an abusive or violent situation, your spouse or common-law
partner's signature is not required on Form RC66, Canada Child Benefits Application, or any other benefit-related form. For additional information, go
to canada.ca/child-family-benefits and select "Leaving an abusive or violent situation."

What to do now
• Make sure all steps of this form are filled out.
• If applicable, attach the documents mentioned under "What to attach to this form."
• Make a photocopy of your form and related documents (if applicable) for your records.
• Send your application to the tax centre that serves your area. Use the chart below to find out the address:

If your province or territory of residence is: Send your application to the following address:
Alberta, British Columbia, Manitoba, Northwest Territories, Winnipeg Tax Centre
Nunavut, Saskatchewan, or Yukon Post Office Box 14005, Station Main
Winnipeg MB R3C 0E3
New Brunswick, Newfoundland and Labrador, Nova Scotia, Sudbury Tax Centre
Ontario, or Prince Edward Island Post Office Box 20000, Station A
Sudbury ON P3A 5C1
Québec Jonquière Tax Centre
2251 René-Lévesque Boulevard
Jonquière QC G7S 5J2

After you apply

Unless you tell the CRA otherwise, the information you give on this form will be used for all benefit programs, including federal, provincial, and territorial
programs. If you do not meet the eligibility criteria for the CCB or any other program, you will need to re-apply once you meet all of the conditions.
Once the CRA has processed your application, a CCB notice will be sent to you. The notice will show if you are eligible, how much you will get (if applicable),
and what information was used to calculate the amount. The CRA's goal is to issue your notice or payment, if applicable, within 11 weeks of receiving your
completed paper application. You will also receive notices for the other programs such as the GST/HST credit and the CCR.
The CRA may also review your situation at a later date to confirm that your information has not changed.

Getting your payments

Direct deposit is a fast, convenient, and secure way to receive your CRA payments directly in your account at a financial institution in Canada. For more
information and ways to enrol, go to canada.ca/cra-direct-deposit or contact your financial institution.
You need to do your taxes on time every year so that we can calculate your payments, even if you had no income in the year. If you have a spouse or
common-law partner, they also need to do their taxes every year.
Make sure your personal information is up to date with the CRA, as this could affect your payments.

If your spouse or common-law partner is a non-resident

If your spouse or common-law partner is a non-resident of Canada, the CRA needs their income information for each year (or part of the year) they were
a non-resident of Canada to determine your child and family benefits and credits. You can provide this information by filling out Form CTB9, Income of
Non-Resident Spouse or Common-Law Partner. Mail it to the tax centre that serves your area or submit it electronically using My account
at canada.ca/my-cra-account. You can also call 1-800-387-1193 to provide the information.

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