Statement of Account Requisition

Personal information on this form is collected under the authority of the Financial Administration Act and will be used for the purpose of researching and preparing the Statement of Property Tax Account as requested by the applicant. If there are any questions regarding the collection and use of this information please contact the Manager of Tax Accounting, Refunds and Financial Analysis, Department of Finance, P.O. Box 3000, Fredericton, NB E3B 5H1. Telephone 1-800-669-7070 or e-mail wwwfin@gnb.ca.

INCOMPLETE APPLICATIONS OR APPLICATIONS RECEIVED WITHOUT PAYMENT WILL NOT BE PROCESSED.

Required fields are indicated with an " * " and bordered in red.

  A single requisition form may be used to request statements of account relating to multiple accounts; however a fee applies to statements produced on each individual account.
  Don't know your PAN? Look it up here.
$ 0.00
$ 25.00
$ 50.00
$ 100.00
$
  Payment must be made in Canadian funds.
ELECTRONIC SIGNATURE
TYPING IN YOUR NAME AND ELECTRONICALLY SENDING THIS FORM CONSTITUTES YOUR ELECTRONIC SIGNATURE