Contents
The Treasury Board, pursuant to paragraph 10(f) of the Financial Administration Act, hereby makes the annexed Payments to Estates Regulations, 1996.
General
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Exceptions
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Repeal
Coming into Force
Schedule I · Application (Subsection 4(1) and section 5)
NOTE: To the best of your knowledge, please indicate the following:Name of the Department:Name of the Program:Estimate of amount claimed:Note: All deletions or alterations are to be initialled by the applicant and the witnesses.Province of IN THE MATTER OF THE ESTATE OF:(Full name of deceased)TO WIT:1 I,(Full name of applicant), age , of(Address)in(City, town or village) in the Province of(Name of province) Postal Code make an application in accordance with section 3 of the Payments to Estates Regulations, 1996.2 That I am the(Relationship) of the late(Full name of deceased) who died at(City, town or village) in the Province of (Name of province) on the(Date) day of(Month), (Year) a copy of whose death certificate is attached to this application, and who died: (check one only) without a will with a will, a copy is attached.(Note: if the will is a holograph, provide proof that it has been probated.)3 That at the time of death, the deceased had his/her permanent residence in (City, town or village), (Province).4 That I am (check one only)[ ] the only person entitled to succeed to the assets of the deceased[ ] one of the persons entitled to succeed to the assets of the deceased, and all other persons so entitled are listed and have signed the release in the form of Schedule II to the Payments to Estates Regulations, 1996.5 That the information provided in this application is correct.6 That I agree to indemnify and save harmless Her Majesty in right of Canada from any loss or damage that may be incurred as a consequence of making the payment to me.7 That I agree to return any overpayment or erroneous payment, which constitutes a debt due to the Her Majesty in right of Canada.(Applicant - signature)(Witness 1 - signature)(Witness 1 - signature) (Witness 1 - Name in capital letters)(Witness 2 - Name in capital letters) (City, town or village), in the Province of (Name of province) (Date) day of (Month), (Year).Note: The witnesses must have no interest in the estate of the deceased and must not be related to the applicant.
Schedule II · Release (Subsection 4(2) and section 5)
LIST OF AND RELEASE BY ALL PERSONS, OTHER THAN THE APPLICANT, ENTITLED TO SUCCEED TO THE ASSETS OF THE SAID DECEASED (as per item 4 of Schedule I to the Payments to Estates Regulations, 1996)NOTE: Not to be completed by the applicant in Schedule I to the Payments to Estates Regulations, 1996. To be signed by the legal guardians on behalf of minors.I hereby release all my interest in the amount payable by Her Majesty in right of Canada to the estate of the late (Full name of deceased)in favour of (Full name of applicant).Full name of persons entitled to inherit | Relationship to the deceased | Age (if minor) | Address and Phone Number | Signature | Witness (name in capital letters and signature) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Federal laws of Canada reproduced under the Reproduction of Federal Law Order (SI/97-5); not the official version. Source: Justice Laws Website.