How do I file NR4 (CAD) with income code of 11 for US taxes?

How do I file NR4 (CAD - T3) with income code of 11 for US taxes? 

I have 2 lines:

Line 1 => has non-resident tax withheld 

Line 2 => has exemption code as "M"

Do I have to file these as two separate forms?