MANITOBA EDUCATION PROPERTY TAX CREDIT ADVANCE
APPLICATION FOR THE YEAR 2010
TO QUALIFY FOR THE MANITOBA EDUCATION PROPERTY TAX CREDIT ADVANCE, THE PROPERTY MUST BE YOUR PRINCIPAL RESIDENCE AND YOU MUST HAVE OCCUPIED IT AS OF JANUARY 1, 2010, AND YOU MUST NOT BE RECEIVING THE CREDIT FOR ANOTHER RESIDENCE. THIS CREDIT MUST BE REPORTED ON YOUR 2010 INCOME TAX RETURN WHEN CLAIMING THE EDUCATION PROPERTY TAX CREDIT. THIS APPLICATION MUST BE FILED ON OR BEFORE NOVEMBER 15th, 2010.
MUNICIPALITY: __________________________________________________________________________ NUMBER: ___________________
(E.G.: City of Winnipeg or Rural Municipality)
NAME OF APPLICANT :
Last First Middle
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*SOCIAL INSURANCE NUMBER :
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MARITAL STATUS : □ Married □ Divorced □ Living Common Law □ Separated □Widowed □Single
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INFORMATION ABOUT YOUR SPOUSE OR COMMON-LAW PARTNER :
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*SOCIAL INSURANCE NUMBER :
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MAILING ADDRESS: POSTAL CODE:
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HOME PHONE: BUSINESS PHONE:
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I declare that, as of January 1, 2010, I was and now am a bona fide resident homeowner of a single family dwelling unit which is my principal residence and which is listed as the only residence on the current tax roll as follows:
OCCUPANCY DATE OF HOME:
DAY MONTH YEAR
ROLL NUMBER: __________________________________ TITLE NUMBER:
Street Address or:
Legal Description (E.G. : Lot, Block, Plan or Section, Township, Range)
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I currently receive the Education Property Tax Credit for another property.
Yes □ No □
TOTAL CURRENT TAXES FOR RESIDENCE FOR 2010
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$
$
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MINIMUM PROPERTY TAX THRESHOLD
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MANITOBA EDUCATION PROPERTY TAX CREDIT APPLIED FOR
(Maximum $650.00)
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I hereby make application for the Manitoba Education Property Tax Credit Advance in accordance with the regulations to the Income Tax Act (Manitoba). This advance is to be credited to the taxes levied for the current year against the above-described property.
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CERTIFICATION: I hereby certify that the information given in this application is true, correct and complete to the best of my knowledge.
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SIGNATURE OF APPLICANT: ________________________________________
APPLICATION DATE: ________________________________________
DD MM YY
For office use only
MUNICIPAL OFFICIAL'S COMMENTS:
FORM REVIEWED BY MUNICIPAL OFFICIAL □
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For Manitoba Tax Assistance Office use only
EPTCA □ MAVAS □
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MAIL TO: Department of Finance
Manitoba Tax Assistance Office
809-386 Broadway
Winnipeg MB R3C 3R6
Winnipeg MB R3C 0P8
PHONE: 1-204-948-2115 FAX: 1-204-948-2263
1-800-782-0771
This personal information is being collected under the authority of the Manitoba Income Tax Act and will be used to determine eligibility for the municipal tax reduction. It is protected by the Protection of Privacy provisions of The Freedom of Information and Protection of Privacy Act. If you have any questions about the collection of this information, contact the Manager of Information Services for the Manitoba Tax Assistance Office at the number listed below. |