Download Declaration of Citizenship and Residency

Ontario Sound Recording Tax Credit
DECLARATION OF CITIZENSHIP AND RESIDENCY
(To be completed by artists, lyricists, composers and music video directors)
Instructions: Please complete all sections of this form.
Recording Title: ______
___________________________________________
Your Legal Name: ________
Your Alias: ________
_______
__________________________________________________
__________________________________________________
Check all that apply:
 Artist or Group Member
 Lyricist
 Composer
 Music Video Director
Current Address: ___________________________________________________________________
(full address including postal code)
With respect to the above recording, I hereby certify and confirm that:
1.
I am (please check one of the following)
□ a Canadian citizen by birth
□ a Canadian citizen by naturalization (date of naturalization: _________________ )
□ a permanent resident of Canada within the meaning of the Immigration Act (date of admission as
permanent resident: _______________________ )
2.
For artists or group members:
Date of contract with sound recording company:
_____________________________________________
I was ordinarily resident in Canada at the time my contract was signed and when the master recording
was made, and my address at that time was:
□ same as above
□
(full address indicating postal code)
For lyricists:
Period during which the lyrics were written: __________________________________________________
I was ordinarily resident in Canada during the time the lyrics were written, and my address at that time
was:
□ same as above
□
_____________________________________________________________________
(full address indicating postal code)
(over)
For composers:
Period during which the music was composed:
__________________________________________________
I was ordinarily resident in Canada during the time the music was written, and my address at that time
was:
□ same as above
□
(full address indicating postal code)
For music video directors:
Date(s) the music video was shot: __________________________________________________
I was ordinarily resident in Canada when the music video was shot, and my address at that time was:
□ same as above
□
(full address indicating postal code)
For all:
3.
I understand that the sound recording company will be relying on this Declaration for its application for
an Ontario Sound Recording Tax Credit (OSRTC), which is jointly administered by the Ontario Media
Development Corporation (OMDC) and the Canada Revenue Agency and may be subject to
government audit. I hereby warrant that the above-noted information is true and correct.
4.
I authorize the OMDC to disclose any and all of the foregoing information to the Canada Revenue
Agency.
5.
The information obtained in connection with this Declaration is collected pursuant to section 94 of the
Taxation Act. The above-noted information shall be used for the purpose of processing the sound
recording company’s application for a tax credit under the OSRTC. Questions about this collection
should be directed to the Director of Tax Credits, OMDC, 175 Bloor St. East, South Tower, Suite 501,
Toronto ON, M4W 3R8, 416-642-6659.
____________________________________________________
Signature of Declarant
_________________________
Date