2. Municipality Name *

   As shown on your assessment notice or tax notice

3. Tax Year*

   The current tax year

5. Section 1 - Notice Type
7. Assessment Notice:*

   1. Annual Assessment

   1. Amended Annual Assessment

   1. Supplementary Assessment

   1. Amended Supplementary Assessment
9. Section 2 - Property Information
10. Assessment Roll or Tax Roll Number*
12. Property Address - as it appears on your assessment notice
14. Address
15. City
16. Province
17. Postal Code
19. Legal Land Description - as it appears on your assessment notice
21. Plan
22. Block
23. Lot
24. ATS (Twp-Rge-Sec-Qtr)
26. Property Type*

    Check all that apply

    1. Residential property with 3 or fewer dwelling units
    2. Residential property with 4 or more dwelling units
    3. Farm land

    1. Non-residential property
    2. Machinery & Equipment
28. Section 3 - Complainant Information
30. Is the complainant the assessed person or tax payer for the property under complaint?*

    1. YES
    2. NO

    Note: If this complaint is being filed on behalf of the assessed person or taxpayer by an agent for a fee or a potential fee the Assessment Complaints Agent Authorization form must be completed by the assessed person or taxpayer of the property and must be submitted with this complaint form.

32. Complainant Name *

    If the complainant, assessed person, or taxpayer is a company, enter the complete legal name of the company. 

34. Mailing Address

    If different from above

36. Address
38. City
39. Province
40. Postal Code
42. Phone Number
43. Fax Number
44. Email Address
46. If applicable, please indicate any date(s) that you are not available for the hearing
48. Section 4 - Complaint Information
50. Check the matter (s) that apply to the complaint*

    Note: Some matters or information may be corrected by contacting the municipal assessor prior to filing a formal complaint

    1. the description of the property or business
    2. the name or mailing address of an assessed person or taxpayer
    3. an assessment amount
    4. an assessment class
    5. an assessment sub-class
    6. the type of property
    7. the type of improvement

    1. school support
    2. whether the property or business is assessable
    3. whether the property or business is exempt from taxation - please refer to Part 10 of MGA section 364.1 (11)
    4. any extent to which the property is exempt from taxation under a bylaw under section 364.1 of the Act
    5. whether the collection ot tax on the property is deferred under a bylaw under section 364.1 ot the Act
    6. a designated officer's refusal to grant an exemption or deferral under a bylaw under section 364 .1 of the Act
52. Section 5 - Reason(s) for Complaint
53. Note: An assessment review board panel must not hear any matter in support of an issue that is not identified on the complaint form.
54. Requested assessed value:*

    Value of Assessment you want considered

56. A Complainant must:*

    •     indicate what information shown on an assessment notice or tax notice is incorrect, 

    •     explain in what respect that Information is incorrect, 

    •     indicate what the correct information is, and 

    •     identify the requested assessed value, if the complaint relates to an assessment. 

58. Additional Documents (Attach any supporting documents)
60. Section 6 - Complaint Filing Fee
62. If the municipality has set filing fees payable by persons wishing to make a complaint, the filing fee must accompany the complaint form, or the complaint will be invalid and returned to the person making the complaint.
64. Fees*

    1. $50.00 for each residential/farmland appeal
    2. $650.00 for each commercial/Industrial appeal.

    Select the fee that applies to you.

66. If the assessment review board panel makes a decision in favour of the complainant, or if all the issues under complaint are corrected by agreement between the complainant and the assessor, and the complaint is withdrawn prior to the hearing, the filing fee will be refunded.
68. Section 7 - Complainant Signature
70. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
72. Print Name*
74. Electronic Signature*
75. Date*
    Date
77. Important Notice: Your completed complaint form and any supporting attachments, the agent authorization form, and the prescribed filing fee must be submitted to the person and address with whom a complaint must be filed as shown on the assessment notice or tax notice prior to the deadline Indicated on the assessment notice or tax notice. Complaints with an incomplete complaint form, complaints submitted after the filing deadline, or complaints without the required filing fee, are invalid.
Leave This Blank:


78. 1. Receive an email copy of this form.
79. Email address

    This field is not part of the form submission.

80. Submit Submit and Print

* indicates a required field