Rc4031 Tax Refund Form – Fill Out and Use This PDF

Part A – Identification (please print)

Last name

First name

Mailing address

Part B – Arrival and departure details

(if this application covers more than one visit to Canada, read the instructions on the back of this form)

City of final departure from Canada or name of border crossing

Part C – Refund calculation

Number of nights of

Is the total amount of your eligible purchases of short-term

Yes

No

If no, do not proceed with this

paid eligible short-term

accommodation and goods, before taxes, CAN$200 or more?

claim.

Does each receipt for eligible goods show the required

Receipts must be for CAN$50

accommodation

Yes

No

minimum purchase amount, before taxes, of CAN$50?

or more.

Did you purchase any individual good(s) valued at CAN$250 or more before taxes?

Yes

No

a) GST/HST paid on eligible short-term accommodation

$

•

(see back of form for more information)

•

b) GST/HST paid on eligible goods

$

c) Total GST/HST refund claimed on eligible short-term accommodation and goods

$

•

[add lines a) and b)]

Part D – Certification
I certify that:
a) The information on this application and in any attachments is true, correct, and complete in every respect.
b) The amount claimed, or any part of it, has not been previously approved for payment or paid.
c) I am not a resident of Canada and the address provided in Part A is my permanent residential address outside Canada.
d) I am the individual identified in Part A, or I am authorized to sign this form on behalf of the person identified in Part A of this form.
It is a serious offence to make a false claim.
Applicant's signature						Year	Month Day Telephone number
COR	POE	POA	PR	Other	DC	NC

Privacy Act Personal Information Bank number RCC/AEU-435.

General Information

Visitors to Canada

Use this form if you are a non-resident visitor to Canada who paid goods and services tax/harmonized sales tax (GST/HST) on eligible short-term accommodation or eligible goods. We must receive your application within one year after the day the tax on the eligible short-term accommodation became payable, and within one year after the day you exported the eligible goods. See page 4 of our pamphlet RC4031, Tax Refund for Visitors to Canada, for details on what qualifies as eligible short-term accommodation and eligible goods.

Include original receipts with your application. We do not accept photocopies or debit or credit card slips. It will take about four to six weeks to process your application.

Note

We do not return the receipts that are sent in with your refund application.

If you are claiming the GST/HST you paid on eligible goods and your first departure flight does not leave from one of the eight international airports, you have to provide alternate forms of proof of export. The international airports are listed on page12 of our pamphlet RC4031, Tax Refund for Visitors to Canada. For proof of export information, see our pamphlet RC4031, or visit our Web site at www.cra.gc.ca/visitors.

If your refund claim covers multiple visits to Canada, enter the earliest arrival date, the latest departure date, and the place of your final departure from Canada on the front of this form. Also attach a list of your various arrival and departure dates, including each place of departure from Canada. If your claim includes eligible goods from various visits, proof of export for the goods is needed from each departure place.

Eligible travel tour packages

If your tour package included eligible short-term accommodation, you can claim up to one half of the full amount of the GST/HST you paid for the tour package, unless you are using the quick calculation option discussed below. Enter the amount you are claiming for short-term accommodation in Part C of this application form. See page 4 of the pamphlet RC4031, Tax Refund for Visitors to Canada, for more information.

Quick calculation option for GST/HST paid on eligible short-term accommodation or tour packages

You can use a quick method to calculate the amount of your GST/HST refund, rather than adding up the actual amount you paid. See page 5 of our pamphlet RC4031, Tax Refund for Visitors to Canada, for more information.

The only method of payment by the Canada Revenue Agency is by cheque.