Required fields are marked with asterisks (*)

Bus Pass Taxable Benefit Annual Acknowledgment

You are required to complete this acknowledgment form based on City records that indicate you have been provided a free annual Guelph Transit bus pass in lieu of a permit for access to a municipal parking lot in downtown Guelph OR or you qualify for a discounted bus pass at 50% of the regular monthly cost.

As a result of the series of Payroll Compliance Audits conducted by the CRA over the past several years, it has been confirmed that the City of Guelph is required to levy a taxable benefit to all staff who receive a City-paid or subsidized bus pass. The taxable benefit is the value of the portion that the City discounts on your behalf.

For example, if you receive a free annual bus pass, valued at $80.00 per month (subject to change), your taxable benefit is $80.00 per month. You do not pay this taxable benefit amount, but income tax will be calculated based on the amount and remitted to the CRA on your behalf.

Retroactive reimbursements to your taxable benefit amount will not be made due to a failure to notify Parking and Payroll of a change in your situation.

Employee Name (First and last name format)

Employee ID #

Tax Year

Are you receiving a free annual bus pass OR a discounted (50%) monthly bus pass from the City of Guelph?:

Free annual bus pass

Discounted (50%) monthly bus pass

If you are you receiving a discounted (50%) monthly bus pass from the City of Guelph, please select the month it is issued for (annual pass holders please select N/A):

I acknowledge that I will be required to complete and submit this form annually as long as I am in possession of a free bus pass OR monthly each time I purchase a discounted bus pass:

I acknowledge that this form should be updated following any change to my possession of a free or discounted bus pass and that no retroactive reimbursements will be made should I fail to promptly notify Parking/Payroll of this change:

Collection of personal information

Personal information is being collected and will be used for the purpose of determining the bus pass taxable benefit, if any, for an employee who has been provided a free or discounted bus pass for Guelph Transit.

Personal information, as defined by Section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), is collected under the authority of the Municipal Act, 2001, and in accordance with the provisions of MFIPPA.

If you have questions about the collection, use or disclosure of this personal information please contact the City’s Information and Access Coordinator at 519-822-1260 extension 2349 or email privacy@guelph.ca.