Form Sde 0073 – Fill Out and Use This PDF

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			For Promoter Use Only
	Human Resources and	Ressources humaines et
	Skills Development Canada	Développement des compétences Canada

	Subscriber-Only
		Basic Canada Education Savings Grant
	Application for :
		Additional Canada Education Savings Grant
	(Use this form only when the Subscriber is also
	the Custodial Parent / Legal Guardian and the	Canada Learning Bond
	Primary Caregiver of the Beneficiary)
	Protected "B" When Completed - Personal Information Banks HRSDC PPU 390 and HRSDC PPU 506

Instructions :

1.Check above all the incentives you wish to apply for.

2.Read this document carefully. If you have any questions, do not hesitate to ask the Promoter.

3.This form is valid only if completed, signed, dated and given to the Promoter. Do not send directly to HRSDC.

4.Please print clearly. Keep a copy for your records.

Joint Subscriber

Last Name

First Name

Middle Name/Initial

(If applicable - may be the

Subscriber' spouse)

Beneficiary

Last Name

First Name

Middle Name/Initial

(Please see explanation

below - Enter name as on

Date of Birth

Social Insurance Number

SIN card)

Male

Female

I y I y I y I y I m I m I d I d I

I I I

I I I

I I I

I

Promoter

Name, Address, Postal Code

Telephone

SDE 0073 (01 - 09) E

Human Resources and	Ressources humaines et
Skills Development Canada	Développement des compétences Canada

Conditions

1.In order for the Basic and Additional Canada Education Savings Grant to be paid, the Beneficiary must be resident in Canada at the time of each contribution to the RESP and for a Canada Learning Bond to be paid, the Beneficiary must be resident in Canada immediately before a Canada Learning Bond payment is made.

2.An Additional Canada Education Savings Grant and/or Canada Learning Bond may be paid only if the RESP has one Beneficiary or, if there is more than one, every Beneficiary is a brother or sister of every other Beneficiary.

3.If the Beneficiary is 16 or 17, at least one of the following must have occurred in order for the Beneficiary to be eligible for the Basic and Additional Canada Education Savings Grant:

•in any four years before the end of the year in which the Beneficiary turned 15, a total of at least $100 per year must have been contributed to one or more RESPs in respect of the Beneficiary, and not withdrawn; or

•a total of at least $2,000 must have been contributed to one or more RESPs in respect of the Beneficiary before the end of the year in which the Beneficiary turns 15, and not withdrawn.

Sharing of your Personal Information

I understand that:

1.The authority of the Government of Canada to collect, share, and use personal information and other information included on this form for the purposes described below is provided under the Department of Human Resources and Skills Development Act, the Canada Education Savings Act and the Income Tax Act. Once under the control of Human Resources and Skills Development Canada, that information is administered in accordance with all applicable laws including the Canada Education Savings Act, the Privacy Act and the Department of Human Resources and Skills Development Act. Once under the control of Canada Revenue Agency, that information is administered in accordance with all applicable laws including the Privacy Act and the Income Tax Act.

2.The information included on this form and the information respecting the RESP may be used by and shared between Human Resources and Skills Development Canada, the Canada Revenue Agency, the promoter and Trustee and their Agents for the administration (which may include policy analysis, research and evaluation) of the Canada Education Savings Act and the Income Tax Act.

3.In order for a payment of the Additional Canada Education Savings Grant and/or Canada Learning Bond to be made, my adjusted family income will be verified with the Canada Revenue Agency. My adjusted family income information will be provided to Human Resources and Skills Development Canada by the Canada Revenue Agency.

Declaration and Consent

I authorize the promoter to ask the Trustee to apply for the grants I have indicated on the previous page in respect of the Beneficiary.

I confirm that I am the Custodial Parent or Legal Guardian and that I am the Primary Caregiver of the Beneficiary.

I confirm that the Beneficiary meets the residency requirements set out above and agree to inform the Trustee if, at any time, there is a change in the Beneficiary's circumstances.

I designate the RESP indicated in this document to receive, in trust, any payments of the Additional Canada Education Savings Grant and/or Canada Learning Bond.

I have read and understood this document. I understand that the Privacy Act gives me (or my authorized representative) the right to access or request correction to my personal information kept in my government file.

Yes

No

I consent to the use and sharing of my personal information as mentioned above.

NOTE: I understand that the provision of the information is voluntary and that I am not required to give my consent; however, if I do not give my consent, Human Resources and Skills Development Canada cannot pay the Basic and/or Additional Canada Education Savings Grant nor the Canada Learning Bond to the Trustee in respect of the RESP Beneficiary.

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