Application for payments in lieu of service charges: Federal properties (printer-friendly form)

From: Public Services and Procurement Canada

Print and complete the following form to apply for payments in lieu of service charges on federal properties. Submit the form by email or mail. Make sure you include with your application all relevant information, such as by-laws and the list of properties.

Notes
  • This form prints on legal size paper (8.5 inches x 14 inches)
  • Your printer settings may need to be adjusted when printing this form


Government of Canada/Gouvernement du Canada
Public Services and Procurement Canada
Services publics et Approvisionnement Canada
Application for payments in lieu of service charges under
section 3(1)(b) of the Payments in Lieu of Taxes Act
Federal properties
Municipality/Taxing authority:


Province:


Tax year for which application is made:


1.
List all federal properties for which you are applying for payment and provide all information requested on the "List of federal properties". (If preferred, you may use a spreadsheet to list the properties if all required columns are included.)
2.
Important - The application must be accompanied by a schedule of the applicable tax rates levied for the tax year.
3.
Attach your service charges by-law.
4.
Does each federal property receive the same services that are available to other taxable properties in the area of service?
  Yes   No ► If no, attach explanation.
5.
Does your taxing authority wish to be considered for a late payment supplement (LPS) under the provisions of the Payments in Lieu of Taxes Act if there is an unreasonable delay in making the payments in lieu of services charges?
  Yes, only if amount exceeds $25.00   Yes, for any amount   No
 
If yes, attach copy of by-law, together with a description of your taxing authority's practice for charging interest on overdue property tax accounts, including rate of interest and compounding frequency.
 
Identify the date from which interest on overdue tax accounts starts to accrue for taxable property owners. ►                                                        

Declaration
I hereby certify that the information given in this application and in any documents attached hereto is true, correctly sets forth the rates and assessments in effect for the tax year for which this application is made and no other department has been billed for these charges.

Signature of authorized officer
Date (yyyy-mm-dd)
Return address
Name and title of authorized officer
Address
Postal code
Telephone number
Fax number
Email

Send one fully completed signed copy of this application and all relevant by-laws to the PILT office that serves your region.

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