Instructions: Please fill out the form to the best of your ability. If you have any questions, please do not hesitate to call tax4nanny at 6470349-6262 or email

Contact Information

  • Last Name
    [group threefieldslastname] [/group]
  • First Name
    [group threefieldsfirstname] [/group]
  • Middle Name
  • Home Number
  • Work Number
  • Cell Number
    [group threefieldscellnumber] [/group]
  • Email Address:
    [group threefieldsemailaddress] [/group]
  • How did you hear about us?
    [group threefieldshdyhau] [/group]

Employer Input

  • Last Name:
    [group employerinputlastname] [/group]
  • First Name:
    [group employerinputfirstname] [/group]
  • Middle Initial:
Employer is the person whom the payroll business number is/should be registered under. Please use LEGAL name.

  • Employer SIN:
  • Birth Date
    • Month
      [group employerinputmonth] [/group]
    • Day
      [group employerinputday] [/group]
    • Year
      [group employerinputyear] [/group]
  • CRA Bus Number (i):
  • WSIB Number (i):
(i) = If you need Tax4Nanny to obtain this for you, please indicate by putting in a question mark in this field.

Employer Address

  • Street #:
    [group employerstreetnumber] [/group]
  • Street Name:
    [group employerstreetname] [/group]
  • Unit/Apartment:
    [group employerapartment] [/group]
  • City:
    [group employercity] [/group]
  • Province:
    [group employerprovince] [/group]
  • Postal Code:
    [group employerpostalcode] [/group]

Note: Employer is the person in the family whom the business number is registered under.

Employee #1 (Nanny, Elder Care Giver, Other)

  • How did you find this employee?:
    [group howdidyoufindthisemployee] [/group]
  • Agency Name:
  • Type:
    [group employeetype] [/group]
  • Employee Last Name
    [group employeelastname] [/group]
  • Employee First Name
    [group employeefirstname] [/group]
  • Employee Middle Name
  • Birth Date
    • Month
      [group employee1birthdaymonth] [/group]
    • Day
      [group employee1birthdayday] [/group]
    • Year
      [group employee1birthdayyear] [/group]
  • Employee SIN:
  • SIN Expiry Date (if applicable):

Employee Address

  • Street #:
    [group employeestreetnumber] [/group]
  • Street Name:
    [group employeestreetname] [/group]
  • Unit/Apartment:
    [group employeeapartment] [/group]
  • City:
    [group employeecity] [/group]
  • Province:
    [group employeeprovince] [/group]
  • Postal Code:
    [group employeepostalcode] [/group]
  • Live In or Live Out:

    [group employeeliveinorliveout] [/group]

  • Effective Start Date:
    • Month
      [group employeeeffectivestartdatemonth] [/group]
    • Day
      [group employeeeffectivestartdateday] [/group]
    • Year
      [group employeeeffectivestartyear] [/group]
  • Termination Date (ii):
    • Month
    • Day
    • Year
(ii)=If you have terminated this employee, please provide termination date.

Net or Gross Salary (for example: $1,000/month net or $25,000/year gross):

  • Amount
    [group employeenetorgrosssalary] [/group]
  • Frequency
    [group employeefrequency] [/group]
  • Net/Gross
    [group employeenetorgross] [/group]
  • How Often Paid (weekly, bi-weekly, 15th and 30th of the month):

    [group employeehowoftenpaid] [/group]

  • Number of hours working per week :

    [group numberofhoursweek] [/group]


  • Cell Phone:
    [group employeebenefitscellphone] [/group]
  • Monthly Amount - Cell Phone:
  • Metropass:
    [group employeebenefitsmetropass] [/group]
  • Monthly Amount - Metropass:
  • Other:
  • Monthly Amount - Other:         

Additional Notes:


[group certifyname] [/group]

  • Date
    • [group certifydatemonth] [/group]
    • [group certifydateday] [/group]
    • [group certifydateyear] [/group]

  • Additional Employees

  • Click to enter in more employees.

Enter Credit Card Info

Please note that your credit card will not be charged before Tax4Nanny contacts you
  • Name on Card:
    [group ccnamec] [/group]
  • Credit Card Number:
  • [group ccnumc] [/group]
  • Expiry:
  • Month
    [group ccexpirymonthc] [/group]
  • Year
    [group ccexpiryyearc] [/group]
  • CCV:
    [group ccvc] [/group]
  • Credit Card Type:
  • [group menu588] [/group]


  • Please advise which package you want to be signed up for*: