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Ahc0208g Form 2013
(Please print)
My title is (e.g. Mr, Mrs, Dr)
My personal health number is
—
My last name is
My first name is
My middle name is
My current mailing address is
City/Town
Province/Territory
Country
Postal code
Section B - Account holder's income information
2012
I filed an income tax return with the Canada Revenue Agency for the year
a.
Yes
If no, I was claimed as a spouse, partner or dependant
No
Yes
If yes, my taxable income was
(line 260 from your income tax...
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