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Financial Hardship Tax Deferral Program Application

If you and/or your spouse are low-income seniors or low-income persons with disabilities, you may be eligible for tax deferrals for your residential property.

Assessment Roll No.

Property Address

How long have you owned / lived in this property?

Applicant / Owner #1 Name (first and last)

Applicant / Owner #2 Name (first and last)

Applicant / Owner #1 Social Insurance Number

Applicant / Owner #2 Social Insurance Number

Applicant / Owner #1 Date of Birth

Applicant / Owner #2 Date of Birth

Applicant / Owner Phone Number

Owner's Address (if different than Property Address)

Have you made any improvements over the past year that would affect your tax levy?

Yes

Comments

Senior Homeowner with a Low Income

Please attach copies of documents as required for income verification:

Notice(s) of Assessment of Income Tax for PROPERTY that was received from Revenue Canada by Applicant and all others occupying the residential home.

Copy of Old Age Security T-4A

Proof of receipt of a registered pension or registered annuity under the Income Tax Act (Canada).

Homeowner with a Low Income and a Disability

Please attach copies of documents as required for income verification:

Notice(s) of Assessment of Income Tax for PROPERTY that was received from Revenue Canada by Applicant and all others occupying the residential home

Proof of receipt of assistance paid under: the Ontario Disability Support Program Act or Family Benefits Act (Ontario); or a disability paid under the Guaranteed Annual Income Systems program for the disabled (include copies of cheque stubs)

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Important Information

A successful applicant appeal may alter the amount of your deferral
The last day for submitting this application is April 30th
The property tax deferral applies to current taxes only and not to tax arrears and the property taxes must remain in good standing
Original documentation must accompany application

Statement to be Signed by the Applicant

I occupy a residential property in the County of Brant and have been assessed as an Owner of such property for at least one year immediately preceding the date of this application. I acknowledge this property is my principal residence and I have not applied for the tax deferral, including changes to any other property this year. I agree to notify the County of any changes, which would affect my eligibility for the tax deferral, including changes to household income or property assessment. I understand that the deferral amount is a special lien and must be repaid to the County once the property changes ownership or ceases to be occupied as my principal residence or I am no longer an eligible low income person. I agree to notify the County if the property changes ownership or if I cease to verify this application.

Applicant Signature

Clear

Printed Name

Date of Signature