SR&ED Financing Application

Please confirm your contact details below

First Name

Last Name

Phone

Legal name of your business

Street

City

What province/territory is your business headquartered in?

Postal code

Business Number

Business description

Your ownership percentage

Is your company a Canadian Controlled Private Corporation (CCPC)?

How many years has your company been in business?

What industry do you operate in?

Total Number of Employees

Do you have any Officers with Ownership Percentage 25% and greater?

YesNo

First Name

Last Name

Phone

Percent Ownership

How many times have you received an SR&ED refund?

Have any of your claims in the last 5 years been selected for a CRA Review or Audit?

YesNoIf you are a first time filer select "No".

What was the year of the audit/review (if multiple, please provide the most recent)?

Please provide brief detail of the review/audit.

Amount of funding requested

Closing cash balance on most recent month end balance sheet (BS)

Net income or (net loss) for the most recent fiscal year YTD Profit & Loss (P&L)

Number of months in the most recent fiscal year

Expected SR&ED claim and/or current YTD accrual

What month is your fiscal year end?

For each fiscal period that you would like to finance, please fill out the following:

Fiscal Year

Status

Refund amount for full year

How do you prepare your SR&ED claim?

What SR&ED consultant/accountant company is helping you with your SR&ED claim?

What is the first and last name of the individual helping to file your SR&ED claim?

What is the email address of the individual helping to file your SR&ED claim?

What is the phone number of the individual helping to file your SR&ED claim?

Do you owe any remittances to the CRA? (e.g. payroll, taxes, etc)

YesNo

Please explain why and how much.

Application Id

Lead Id

SumField

CountField

Status is Fiscal

Status is Claim

Contact Information

SR&ED Financing Application

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