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Finance, Energy and
M unicipal Affairs
Taxation and
Property Records
Declaration of Inter-family Transfer
In the matter of the Real Property Transfer Tax Act 2005
Freedom of Information and Protection of Privacy
The personal inform ation requested on this form is collected under the authority of Section 31(c) of the Freedom of
Information and Protection of Privacy Act R.S.P.E.I. 1988, and is used for adm inistering the Real Property
Assessment Act. Questions on the collection and use of this inform ation can be directed to Manager, Corporate
and Tax Adm inistration Services at (902) 368-5137.
W e,
of
Nam e of Grantee/Recipient
Mailing Address
of
Nam e of Grantor/Donor
Mailing Address
M ake oath and say as follow s:
1)
that we have knowledge of the m atters hereinafter deposed to;
2)
that we are the Grantee/Recipient and Grantor/Donor of the real property described in the legal description
contained within the deed of conveyance attached hereto;
3)
that the Grantor/Donor is the
of the Grantee/Recipient;
(Relationship)
Insert one of the following above: father, mother, spouse, common-law spouse, grandfather,
grandmother, son, daughter, brother, sister, grandson, granddaughter, son-in-law, daughter-inlaw, father-in-law, mother-in-law, brother-in-law, sister-in-law, step-father, step-mother, step-son or
step-daughter.
If the relationship in number 3) above is common-law spouse, the common-law relationship has
been in existence for the six-month period immediately preceding the transfer.
4)
that the real property is being acquired by the said Grantee/Recipient for m onetary consideration not
exceeding $1.
Sworn to before m e at
in
)
County
)
in the province (state) of
)
this
)
Signature of Grantor/Donor
day
Ad 20
)
)
)
A notary public or a com m issioner for taking affidavits in the
Suprem e Court or a notary public in and for the province (state) of
)
)
)
Signature of Grantee/Recipient
)
D ecem ber 2011
11PT 15-30751