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Protected B when completed

Request for Loss Carryback
• Use this form to request for a carryback of a loss from 2023 to any of the three previous tax years. Attach the completed form either to your 2023 income
tax and benefit return or to your request for an adjustment, and send it to your tax centre. You can also send the form on its own. For tax centre
addresses, go to canada.ca/cra-offices.
• You cannot carry back a loss to reduce any late-filing penalty for the year to which the loss is being applied.
• You cannot carry back losses of a limited partnership.
• Complete only the sections that apply to you, and sign the certification section.
• For more information on losses, see Interpretation Bulletin IT-232, Losses – Their Deductibility in the Loss Year or in Other Years.

Part 1 – Identification
Name Social insurance number (SIN)

Address City Prov./Terr. Postal code

Part 2 – Non-capital loss for carryback

Enter the amounts without brackets.
If you have an amount on line 22400 of your return, deduct the amount against either your investment income or loss, or your partnership (limited or non-
active partners) income or loss, whichever applies. Do not deduct the amount twice.

Calculating income and loss

Income Loss

Employment income or loss (lines 10100 and 10400 minus lines 20700, 21200, 22900, and 23100) . . . . .
Investment income or loss (lines 12000 and 12100 minus line 22100) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Partnership (limited or non-active partners) income or loss (from line 12200) . . . . . . . . . . . . . . . . . . . . . . . .
Rental income or loss (from line 12600) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Business income or loss (from line 13500) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Professional income or loss (from line 13700) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Commission income or loss (from line 13900) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Farming income or loss (from line 14100) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fishing income or loss (from line 14300) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Taxable capital gains (from line 12700) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Non-taxable income (from line 14700) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Net capital losses of other years (from line 25300) (see note 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Capital gains deduction (from line 25400) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Business investment loss (from line 21700). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Canadian Armed Forces personnel and police deduction (from line 24400) . . . . . . . . . . . . . . . . . . . . . . . . . nil

Security options deductions (from line 24900) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Other payments deduction (from line 25000) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Income exempt under a tax treaty, adult basic education tuition assistance, and the deduction for
employees of prescribed international organizations (the portion included on line 25600). . . . . . . . . . . . . . . nil
Income from other sources (from lines 11300, 11400, 11500, 11600, 11700, 11900, 12500, 12800, 12900,
13000, and 13010). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . nil

Total income: Add lines listed under "Income" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A

Total loss: Add lines listed under "Loss" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B

Note 1: If the taxpayer is deceased, see Guide T4011, Preparing Returns for Deceased Persons.

Continue Part 2 on next page ►

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Protected B when completed
Part 2 – Non-capital loss for carryback (continued)
Calculating non-capital loss for carryback

Total loss from amount B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C

Total income from amount A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D

Total of amounts on lines 20800, 21000, 21300, 21400, 21500, 21900, 22000, 22200, 22215, 22300,
23200, and 23500 (except amounts in note 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E
Subtotal: Amount D minus amount E (if negative, enter "0") ► F
Subtotal: Amount C minus amount F (if negative, enter "0") G

Loss from farming and fishing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . H

Income from farming and fishing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I

Subtotal: Amount H minus amount I (if negative, enter "0") J

The lesser of amount G or J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . K

Total non-capital loss for the year available for carryback: Amount G minus amount K (if negative, enter "0"). . . . . . . . . . . . . . . . . . . . L

Non-capital loss to be applied to 2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66250

Non-capital loss to be applied to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66260

Non-capital loss to be applied to 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66270

Subtotal: Add lines 66250, 66260, and 66270. The subtotal cannot be more than amount L ► M
Balance of non-capital loss available for carryforward: Amount L minus amount M

Note 2: The following amounts will reduce the income or increase the loss from the sources to which they relate:
• capital cost allowance relating to investment in Canadian motion picture films (see line 23200)
• deductions allowed under subsections 20(11) and 20(12) of the federal Income Tax Act. For more information, see Interpretation
Bulletin IT-506, Foreign Income Taxes as a Deduction From Income
• repayments of a shareholder's loans

Part 3 – Farming or fishing loss for carryback

Farming or fishing loss available for carryback (amount K from Part 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . N

Farming or fishing loss to be applied to 2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66300

Farming or fishing loss to be applied to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66310

Farming or fishing loss to be applied to 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66320

Subtotal: Add lines 66300, 66310, and 66320. The subtotal cannot be more than amount N ► O
Balance of farming or fishing loss available for carryforward: Amount N minus amount O

Part 4 – Restricted farm loss for carryback

The amount you deduct in any year cannot be more than your net farming income for that year. If you have no net farming income in any of those years,
you cannot deduct any restricted farm loss.
Restricted farm loss for the year available for carryback (see Chapter 5 of Guide T4037, Capital Gains) . . . . . . . . . . . . . . . . . . . . . . . . P

Restricted farm loss to be applied to 2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66480

Restricted farm loss to be applied to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66490

Restricted farm loss to be applied to 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66500

Subtotal: Add lines 66480, 66490, and 66500. The subtotal cannot be more than amount P ► Q
Balance of restricted farm loss available for carryforward: Amount P minus amount Q

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Part 5 – Net capital loss for carryback
Use this section to apply 2023 net capital losses only. You can only apply 2023 net capital losses against taxable capital gains.
Applying a net capital loss carryback will result in a reduction of the capital gains deduction, if claimed, in the year(s) of the loss application.
It may also reduce capital gains deductions you claimed in the following years.
For more information, see Chapter 5 of Guide T4037.
2023 net capital loss from line 19900 on Schedule 3, Capital Gains (or Losses), available for carryback (see note 3) . . . . . . . . R

Net capital loss to be applied to 2020 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66360

Net capital loss to be applied to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66370

Net capital loss to be applied to 2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66380

Subtotal: Add lines 66360, 66370, and 66380. The subtotal cannot be more than amount R ► S
Balance of net capital loss available for carryforward: Amount R minus amount S (see note 4)

Note 3: If you have a net capital loss on line 19900 of Schedule 3, enter this amount. If you have a net capital gain on line 19900, enter "0."
Note 4: For information on net capital loss available for carryforward, see Chapter 5 of Guide T4037.

Part 6 – Listed personal property loss for carryback

Amount of listed personal property losses that is more than listed personal property gains for the year available for
carryback (see Chapter 5 of Guide T4037) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . T

Listed personal property net loss to be applied to 2020 listed personal property net gains . . . . 66420

Listed personal property net loss to be applied to 2021 listed personal property net gains . . . . 66430

Listed personal property net loss to be applied to 2022 listed personal property net gains . . . . 66440
Subtotal: Add lines 66420, 66430, and 66440. The subtotal cannot be more than amount T ► U
Balance of listed personal property loss available for carryforward: Amount T minus amount U

Part 7 – Certification
This form must be signed and dated by the individual or the authorized representative.

First name Last name

Telephone number

I certify that the information given on this form is correct and complete.

Signature Date (YYYYMMDD)

► 66550

Personal information (including the SIN) is collected and used to administer or enforce the Income Tax Act and related programs and activities including administering tax, benefits,
audit, compliance, and collection. The information collected may be disclosed to other federal, provincial, territorial, aboriginal or foreign government institutions to the extent authorized
by law. Failure to provide this information may result in paying interest or penalties, or in other actions. Under the Privacy Act, individuals have a right of protection, access to and
correction of their personal information, or to file a complaint with the Privacy Commissioner of Canada regarding the handling of their personal information. Refer to Personal
Information Bank CRA PPU 005 on Information about Programs and Information Holdings at canada.ca/cra-information-about-programs.

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