Every year, the Canada Revenue Agency (CRA) issues a T1 General tax form to all taxpayers in Canada. This form is used to report income and compute taxes payable for the year. However, there are certain circumstances in which a taxpayer may be required to file Form C105B instead of the T1 General. In this blog post, we will explore when you are required to file Form C105B, and what information is included on this form. We will also provide an overview of how to complete Form C105B correctly. Let's get started!
| Question | Answer |
|---|---|
| Form Name | Form C105B |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | mesical certificate for cervice, stcw medical certificate form, certificate of service for petrus motlonye, medical certificate for service at sea ilo a |
MEDICAL CERTIFICATE FOR SERVICE AT SEA
(In accordance with ILO /WHO D.2/ 1997 & STCW Reg I/9 and MLC Reg 1.2)
1
Family Name
Given Names
Date of birth (day/month/year)
Sex:
Male
Female
Home address
Passport No./Discharge Book No.:
Nationality :
I have evaluated the above named examinee according to ____________________________________
(national law, regulation or other requirement)
On the basis of the examinee’s personal declaration, my clinical examination and diagnostic test results recorded on the medical examination form, I declare the examinee:
Fit for |
|
Not fit for |
|
|
|
Deck service |
Engine service |
Catering service |
Other services |
Fit |
|
|
|
|
Unfit |
|
|
|
|
Without restrictions |
|
With restrictions |
|
|
Visual aid required |
Yes |
No |
|
|
Chest |
|
normal |
not performed |
|
Bacteriological stool test*1 |
negative |
not performed |
||
Parasitical stool test*2 |
|
negative |
not performed |
|
Vaccination records
satisfactory
to be renewed
Describe any restrictions (e.g., specific position, type of ship, trade area):
Place of examination: ___________________ Date (day/month/year) _____/_____/_____
Official stamp (also print name of medical examiner):
Signature of medical examiner: ___________________
Authorised by: _________________________________ (competent authority)
I acknowledge that I have been advised of the content of the medical examination form.
Examinee’s signature: ___________________
(To be signed in the presence of the medical examiner)
MEDICAL EXAMINATION IS VALID 2 YEARS UNTIL Date (day/month/year) __ /_ _/__
Form C105B
Version: 2 Issued: 10/05
Revision: 1 Issued: 02/12
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