Application for Tax Rebate

Eligible Charities and Other Similar Organizations

County of Wellington By-Law No. 5572-18

Date of Application

Rebate Request for Taxation Year

Name of Organization

Address

Telephone Number

Email Address

Assessment Roll Number

Charitable Registration No.

Contact Name

Length of time at this Address

Date of Occupancy (if less than one year)

Previous Address (if occupancy is less than one year)

Mailing Address if different than above

Name of Landlord

Landlord's Telephone Number

Upload proof of taxes paid for the year

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