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Ann e Employer's name Nom de l'employeur Dividends from Canadian corporations Dividendes de soci t s canadiennes Actual amount of eligible dividends Montant r el des dividendes d termin s T4PS (25) Protected B when completed / Prot g B une fois rempli 30 Employer's account number Num ro de compte de l'employeur Actual amount of dividends other than eligible dividends Montant r el des dividendes autres que des dividendes d termin s 54 Social insurance number Nu.

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