FILM INCENTIVE BC / SCHEDULE A
DECLARATION OF BRITISH COLUMBIA RESIDENCY FOR CANADIAN PRODUCER
CANADA
)
IN THE MATTER OF the Film Incentive BC administered by
)
Creative BC Society (“CREATIVE BC”)
Province of
)
on behalf of the Certifying Authority
British Columbia
)
)
AND IN THE MATTER OF the application of
)
)
(the “Production Corporation”)
(Name of Production Corporation)
)
)
with respect to
)
TO WIT
)
(the “Production”)
(Name of Production)
)
I, (Name of Declarant)
, residing at
(Address, City, Province, Postal code)
DO SOLEMNLY DECLARE that:
I am a(n) (Occupation)
Corporation for the Production from and as such am providing/have provided my services to the Production
to (Commencement date)
.
(Completion date)
At all times during the Production, by virtue of birth, naturalization or landing, I am lawfully in Canada (Canadian citizen
or permanent resident), and I am and will at all material times be ordinarily resident in Canada for the purposes of the
Income Tax Act (Canada).
I was a resident of British Columbia on the December 31st of the year preceding the year in which principal
photography of the Production begins/began.
I file personal income tax returns as a resident of British Columbia and have done so or will do so for the income tax
year immediately preceding the one in which principal photography for the Production begins/began.
I confirm that I will provide satisfactory documentary proof of the matters referred to in paragraphs 1, 2, 3 and 4
above to the Certifying Authority, CREATIVE BC and the Canada Revenue Agency upon written request.
I understand that the Production Corporation will be relying on this declaration for its tax credit application pursuant
to Part 5 of the Income Tax Act (British Columbia), which may be subject to a Canada Revenue Agency audit, and
hereby warrant that the above-noted information is true and accurate to the best of my knowledge and belief.
Signature of Declarant
Date
***This document should only be completed by BC-based individuals who
are Canadian receiving a producer or producer-related credit***
WARNING: False or misleading information will result in automatic denial of the tax credits, and may lead to
prosecution under the Income Tax Act (British Columbia).
The Certifying Authority is the Minister of Jobs, Tourism and Skills Training. Film Incentive BC is administered on behalf
of the Certifying Authority by CREATIVE BC. Inquiries and applications should be directed to CREATIVE BC, 2225 West
Broadway, Vancouver, BC, V6K 2E4.
2225 WEST BROADWAY, VANCOUVER, BC V6K 2E4 / TEL +1 604 736 7997 / [email protected] / CREATIVEBC.COM
JANUARY 2014