"Seniors Education Property Tax Deferral Program Non-resident Borrower Form" - Saskatchewan, Canada

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Seniors Education Property Tax Deferral Program
Non-Resident Borrower Form
This form is a support document to accompany a Seniors Education Property Tax Deferral Program application.
Each Non-Resident Borrower (as defined below) must complete an individual copy of this form. If there is no
Non-Resident Borrower, this form is not required.
Who is a Non-Resident Borrower?
Individuals are considered Non-Resident Borrowers only if both of the following statements are true:
1. They are one of the owners of the property listed on a Seniors Education Property Tax Deferral Program
application (i.e. they are listed on the property title).
AND
2. They do not live in the property as their principal residence.
Applicant(s)
First Name
Middle Name
Last Name
1
First Name
Middle Name
Last Name
2
Property Address
(must be applicant’s principal residence)
Property Address
Town/City
Postal Code
Non-Resident Borrower
First Name
Middle Name
Last Name
Date of Birth (mm/dd/yyyy)
Social Insurance Number
Home Phone
Cell Phone
Email
Mailing Address
Town/City
Postal Code
saskatchewan.ca/shc |
repairstaff@gov.sk.ca | 1-800-667-7567
| Page 1 of 3
Seniors Education Property Tax Deferral Program
Non-Resident Borrower Form
This form is a support document to accompany a Seniors Education Property Tax Deferral Program application.
Each Non-Resident Borrower (as defined below) must complete an individual copy of this form. If there is no
Non-Resident Borrower, this form is not required.
Who is a Non-Resident Borrower?
Individuals are considered Non-Resident Borrowers only if both of the following statements are true:
1. They are one of the owners of the property listed on a Seniors Education Property Tax Deferral Program
application (i.e. they are listed on the property title).
AND
2. They do not live in the property as their principal residence.
Applicant(s)
First Name
Middle Name
Last Name
1
First Name
Middle Name
Last Name
2
Property Address
(must be applicant’s principal residence)
Property Address
Town/City
Postal Code
Non-Resident Borrower
First Name
Middle Name
Last Name
Date of Birth (mm/dd/yyyy)
Social Insurance Number
Home Phone
Cell Phone
Email
Mailing Address
Town/City
Postal Code
saskatchewan.ca/shc |
repairstaff@gov.sk.ca | 1-800-667-7567
| Page 1 of 3
Non-Resident Borrowers must consent to the release of any of their personal information reasonably required by
Saskatchewan Housing Corporation (SHC) for the purposes of this program, by signing the Consents provided below.
Certification/Consent of Non-Resident Borrower
I understand that if the Applicant is approved for funding under the Seniors Education Property Tax Deferral Program
(the Program), as a registered owner of the property, I will be required to sign any loan documents provided by SHC,
including a mortgage of my interest in the property in favour of SHC for the amount of the program loan.
I also understand that the Applicant’s enrollment in the Program does not obligate SHC to advance funds to the
Applicant. Further, the amount of any funds advanced by SHC to the Applicant may change from year to year, and
may be any amount determined by SHC, up to but not greater than the amount of the education portion of the
property taxes for the property for that calendar year.
I acknowledge that the property taxes for the property must be paid in full, regardless of whether or not the
Applicant’s application to this program has been processed and a loan has been advanced.
I hereby consent to the collection, use and disclosure by SHC, and any Government of Saskatchewan employee who
provides services to SHC, of my personal information that is requested on this Non-Resident Borrower form or that is
otherwise reasonably required by SHC, for the following purposes:
To verify any information collected by SHC for the purpose of this application or any participation by the
Applicant(s) in the Program;
To administer the Program should the Applicant(s) qualify;
To collect any amount owing to SHC pursuant to the Program;
For research purposes to assess the effectiveness of the Program;
For audit and evaluation purposes to Ministries of the Government of Saskatchewan, including but not limited to
the Ministry of Finance and the Ministry of Social Services.
I am providing this consent voluntarily, in support of this application by the Applicant(s), to participate in the Program.
I understand that:
This consent will continue for two (2) years following the file closure with this program, unless my consent
is withdrawn earlier. My consent may be withdrawn at any time by providing written notice of withdrawal
to SHC at the address provided; the withdrawal of consent will be effective on the date it is received by SHC.
Withdrawal of my consent may prevent the Applicant(s) from continuing to participate in the Program.
If I withdraw my consent, SHC and any Government of Saskatchewan employees who provide services to SHC
will no longer collect personal information or use or disclose the information already collected pursuant to
this consent. They may continue to collect, use and disclose personal information if they are authorized to do
so by law without my consent.
The information collected by SHC related to my participation in the Program, and any loan provided by SHC
pursuant to the Program, will be retained and disposed of in accordance with The Archives and Public Records
Management Act of the Province of Saskatchewan.
I hereby certify that all the information contained in this form is true, complete, and correct.
Non-Resident Borrower
Signature
Date (mm/dd/yyyy)
saskatchewan.ca/shc |
Seniors Education Property Tax Deferral Program - Non-Resident Borrower | Page 2 of 3
repairstaff@gov.sk.ca | 1-800-667-7567
Completed Forms
Applicant(s) must attach each completed Non-Resident Borrower
form, if applicable, to their application package before sending it
to:
Seniors Education Property Tax Deferral Program
Saskatchewan Housing Corporation
11th Floor - 1920 Broad Street
Regina, SK S4P 3V6
Phone:
1-800-667-7567 or 306-787-4177
Fax:
306-798-3110
Email:
repairstaff@gov.sk.ca
Privacy Questions or Concerns
If you have any questions or concerns about the collection, use, or
disclosure of personal information, you may contact:
Access and Privacy
Legislation and Information Management
Ministry of Social Services
17th Floor - 1920 Broad Street
Regina, SK S4P 3V6
Phone:
306-787-0227
Fax:
306-798-5550
Email:
access-privacySS@gov.sk.ca
saskatchewan.ca/shc |
Seniors Education Property Tax Deferral Program - Non-Resident Borrower | Page 3 of 3
repairstaff@gov.sk.ca | 1-800-667-7567
Page of 3