Request for Property Tax Allowance ( Maximum $300 )

Steps to submitting an online request:

Step 1.	Tax Benefit Program - Information
2.	Fill in the required information below. Confirm and correct required information (If you wish, print a copy for your files using your browser's print button).
3.	Click "Submit Request".
4.	An online confirmation of the request received will appear on your screen. It is recommended you print this page for your records.

* Required fields

*	Property Account Number:
*	Applicant’s Social Insurance Number:
	Spouse’s Social Insurance Number:
	I have been the registered owner of this property since:	(yyyy/mm/dd)

Property Information
*	Name:
*	Mailing Address:
*	City, Town or Village:
*	Province:
*	Postal Code:
*	Location of Property:
*	City, Town or Village:
*	Tel(Home):	ex:(506)555-4567
	Tel(Work):	ex:(506)555-4567
*	Marital Status on January 1 of year of application:
Note: Name of Applicant Must be Assessed Owner on January 1 of each year of application

Maximum of $300 taxable income $22,000 or less
Maximum of $200 taxable income $22,001 - $25,000
Maximum of $100 taxable income $25,001 - $30,000

Application Income Information*

Year of Application:	Total Taxable Income of Applicant: (Year Prior to year of application)	Total Taxable Income of Spouse or Co-Habitant Spouse: (Year Prior to year of application)	Combined Total Taxable Income: (Year Prior to Year of Application)	Maximum Combined Total Taxable Income:
	$	$	$	$30,000
	$	$	$	$30,000
	$	$	$	$30,000
	$	$	$	$30,000

Please do not add commas when recording income. Example 7306.00 and not 7,306.00.

* Note: Income reported must be the Total Taxable Income for both the applicant and spouse/co-habitant spouse from Line 26000 of the Income Tax Return for the year prior to the year of application. Combined Total Taxable Income of applicant and spouse cannot exceed $30,000 in the year prior to year of application.

Disclosure Statement

I hereby certify that the information on this form is correct to the best of my knowledge and belief. I understand that the above information will be verified with Canada Revenue Agency and that my property tax account balance may be adjusted upon verification. I recognize that if an application is not submitted, the allowance will not be granted. Anyone who knowingly makes a false or leading statement in an application is guilty of an offense and is liable on conviction to a fine of not more than $5000.00.
Click to confirm that you agree with the above statement *

TYPING IN YOUR NAME AND ELECTRONICALLY SENDING THIS FORM TO SERVICE NEW BRUNSWICK'S ASSESSMENT SERVICES BRANCH CONSTITUTES YOUR ELECTRONIC SIGNATURE

	* Signature	* Date(yyyy/mm/dd)

	* Email Address

IF YOU HAVE READ THE ABOVE DISCLOSURE STATEMENT AND ENTERED ALL

RELEVANT INFORMATION, CLICK ON "SUBMIT FORM" (ONLY ONCE)

TO SUBMIT YOUR APPLICATION

IF YOU WISH, PRINT A COPY FOR YOUR FILES USING YOUR BROWSER'S PRINT FUNCTION.