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    Identity Theft and Suspicious Activity Declaration Form For Individual, Business and Trust

    Uploaded by

    Jennifer Leet
    This document is an identity theft and suspicious activity declaration form for individuals, businesses, and trusts to report unauthorized activity to the Canada Revenue Agency (CRA). It requests information such as name, address, account type (individual, business, or trust), account number, questions about suspicious notices or payments, and which information the individual suspects has been compromised in order to place protections on the individual's CRA account. The individual is to print, complete, and fax the form to have protections placed on their account within 14 days.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Identity Theft and Suspicious Activity Declaration Form For Individual, Business and Trust

    Uploaded by

    Jennifer Leet
    62 views2 pages
    This document is an identity theft and suspicious activity declaration form for individuals, businesses, and trusts to report unauthorized activity to the Canada Revenue Agency (CRA). It requests information such as name, address, account type (individual, business, or trust), account number, questions about suspicious notices or payments, and which information the individual suspects has been compromised in order to place protections on the individual's CRA account. The individual is to print, complete, and fax the form to have protections placed on their account within 14 days.

    Original Description:

    CRA Identity theft and suspicious activity declaration form for individual, business and trust

    Original Title

    rc213-22e

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    © © All Rights Reserved

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    This document is an identity theft and suspicious activity declaration form for individuals, businesses, and trusts to report unauthorized activity to the Canada Revenue Agency (CRA). It requests information such as name, address, account type (individual, business, or trust), account number, questions about suspicious notices or payments, and which information the individual suspects has been compromised in order to place protections on the individual's CRA account. The individual is to print, complete, and fax the form to have protections placed on their account within 14 days.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    62 views2 pages

    Identity Theft and Suspicious Activity Declaration Form For Individual, Business and Trust

    Uploaded by

    Jennifer Leet
    This document is an identity theft and suspicious activity declaration form for individuals, businesses, and trusts to report unauthorized activity to the Canada Revenue Agency (CRA). It requests information such as name, address, account type (individual, business, or trust), account number, questions about suspicious notices or payments, and which information the individual suspects has been compromised in order to place protections on the individual's CRA account. The individual is to print, complete, and fax the form to have protections placed on their account within 14 days.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Protected B when completed

    Identity theft and suspicious activity declaration form


    for individual, business and trust
    Introduction
    This information will be shared only with the Canada Revenue Agency (CRA). If you want to report unauthorized activity to another government organization, you
    should contact them directly.
    If you see changes to your CRA individual, business or trust account information that you did not request, or if you think that your CRA account information has
    been compromised, please fill in this form to report your concern to the CRA. To place immediate protections on your account you can also call:
    Identity Protection Services at 1-833-995-2336 or, if you use a teletypewriter (TTY) please call 1-800-267-7622
    Business Enquiries at 1-800-959-5525
    Trust Account Enquiries at 1-800-959-8281

    Account Type
    Please check the type of account and provide the account number:

    Individual Social insurance number (SIN):

    Business Business number:

    Trust Trust account number:

    Contact Information
    First name Last name

    Date of birth Telephone number Time zone


    Best time to call: morning afternoon evening

    Address City Province Postal code

    Questions
    Did you receive a notice of assessment for a return that you or your authorized representative did not file?
    Yes No n/a

    Did you receive an email from the CRA about changes to your account that you did not authorize?
    Yes No n/a

    Did you receive a letter from the CRA about changes to your account that you did not authorize?
    Yes No n/a

    Did you receive a phone call from the CRA about changes to your account that you did not authorize?
    Yes No n/a

    Did you see wrong information in your file in My Account or My Business Account?
    Yes No n/a

    Did you receive a T4A slip for COVID 19 emergency or recovery benefits that you did not receive or claim?
    Yes No n/a

    Are you expecting payments that you did not receive?


    Yes No n/a

    Individual: What information do you suspect has been compromised?


    income tax and benefit return
    social insurance number
    Canada emergency response benefit / Canada recovery benefit
    Canada child benefit
    goods and services tax credit / harmonized sales tax credit
    Canada Dental Benefit
    One-time top-up to the Canada Housing Benefit

    RC213 E (22) (Ce formulaire est disponible en français.) Page 1 of 2


    Protected B when completed
    information in My Account
    financial information
    representative information
    contact information:
    postal address
    email address
    phone number
    other (explain in the dialogue box below)

    Business: What information do you suspect has been compromised?


    T2 corporation income tax return
    payroll account
    GST/HST account
    Canada emergency wage subsidy/Canada emergency rent subsidy/Canada recovery hiring program
    My Business Account
    financial information
    contact information:
    shareholder/owner
    representative
    postal address
    email address
    phone number
    other (explain in the dialogue box below)

    Trust: What information do you suspect has been compromised?


    trust income tax and information return
    financial information
    contact information:
    trustee/beneficiary
    representative
    postal address
    email address
    phone number
    other (explain in the dialogue box below)

    Dialogue box

    Submission message
    Please complete and print this form. Send the form to Identity Protection Services by fax at: 1-833-635-2482. Protections will be placed on your account once
    the form is processed.
    If you do not receive a call within 14 days:
    For Individual accounts please call Identity Protection Services at 1-833-995-2336 or if you use a teletypewriter (TTY) please call 1-800-267-7622
    For Business accounts please call Business Enquiries at 1-800-959-5525
    For trust accounts please call Trust Account Enquiries at 1-800-959-8281

    RC213 E (22) Page 2 of 2

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