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Request to Remove an Excess FHSA Amount — Designated Withdrawal and Designated Transfer (Form RC727)
[YOUR FULL NAME]
[YOUR MAILING ADDRESS]
Telephone: [PHONE] · Email: [EMAIL]
[NAME OF YOUR FHSA ISSUER]
[BRANCH OR REGISTERED PLANS DEPARTMENT]
[ISSUER'S ADDRESS OR SECURE MESSAGE CHANNEL]
[DATE]
Re: First home savings account no. [FHSA ACCOUNT NUMBER] — excess FHSA amount of $[TOTAL EXCESS] as of [DATE]
Dear Sir or Madam,
I hold the FHSA shown above with you. In [YEAR] I contributed to my FHSAs and also transferred money from my RRSPs to my FHSAs. Together these amounts are more than my FHSA participation room for [YEAR], so I have an excess FHSA amount. I want to remove it now, without including it in my income, by designating it under Form RC727, which I enclose signed.
1. How the excess arose
Item Date(s) Amount
Contributions to my FHSAs this year [DATES] $[CONTRIBUTIONS]
Direct transfers from my RRSPs to my FHSAs this year [DATES] $[RRSP TRANSFERS]
Excess FHSA amount at the end of last year $[0 OR AMOUNT]
Less: my FHSA participation room for [YEAR] −$[ROOM]
Less: designated amounts and taxable withdrawals already made this year [DATES] −$[0 OR AMOUNT]
Excess FHSA amount today [DATE] $[TOTAL EXCESS]
2. What I ask you to do
Because the excess comes from both contributions and RRSP transfers, I ask you to split it as follows:
Designated withdrawal of $[AMOUNT A] from my FHSA, paid to [MY CHEQUING ACCOUNT ENDING … / CHEQUE TO MY ADDRESS]. This amount is not more than my contributions to my FHSAs to date, less any earlier designated withdrawals.
Designated transfer of $[AMOUNT B] directly from my FHSA to my [RRSP / RRIF] no. [PLAN NUMBER] at [RECEIVING INSTITUTION]. This amount is not more than my transfers from RRSPs to my FHSAs to date, less any earlier designated transfers.
Amount A plus amount B equals $[TOTAL EXCESS] and is not more than my excess FHSA amount today.
Please do not process any part of this as an ordinary taxable withdrawal. If you cannot process either designation as requested, please contact me before you act.
3. Confirmation
Please confirm in writing by [DATE — 10 DAYS FROM TODAY] the dates and amounts processed, and report them on my T4FHSA slip for [YEAR] (designated transfers in box 36, designated withdrawals in box 38).
Yours faithfully,
____________________
[YOUR FULL NAME]
SIN: [SOCIAL INSURANCE NUMBER — ONLY IF YOUR ISSUER ASKS FOR IT]
Enclosed: Form RC727, signed ([ONE FORM / TWO FORMS]); [STATEMENT SHOWING CONTRIBUTION AND TRANSFER DATES]
For me
[ ] Excess first arose in: [MONTH] — 1% tax for each month with an excess
[ ] Withdrawal (A) not more than my contributions; transfer (B) not more than my RRSP transfers
[ ] Confirmation received on [DATE]; T4FHSA boxes 36 and 38 checked
[ ] RC728 with Schedule A filed and tax paid by June 30, [NEXT YEAR]