Free untitled - Canada

Canada Revenue Agency

Agence du revenu du Canada

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FEDERAL EXCISE GASOLINE TAX REFUND PROGRAM You may be eligible for the Federal Excise Gasoline Tax Refund Program if you are: a registered charity, as defined in the "Income Tax Act"; a registered Canadian amateur athletic association as defined in the "Income Tax Act"; or an individual who has a permanent mobility impairment and cannot safely use public transportation, as certified by a qualified medical practitioner. How the program works The program allows you to claim a refund of part of the excise tax on gasoline at the rate of $0.015 per litre or $0.0015 per kilometre. To qualify for a refund, the gasoline you buy must be for your use and not for resale. continue on next page
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Diesel fuel, heating fuel, propane, and aviation fuel does not qualify for an excise tax refund. Also, gasoline you buy for personal use does not qualify for a refund unless you are an individual with a mobility impairment. How to claim a refund To claim your refund, complete the attached refund application form. Keep one copy for your records and send one to Federal Excise Gasoline Tax Refund, Summerside Tax Centre, Suite 101, 275 Pope Road, Summerside PE C1N 6E7. Please allow up to 60 days to process your refund. When to claim a refund If your claim is less than $200, you can submit it in each six-month period ending June 30 or December 31. Make your claim no later than one month after the end of the six-month period. For example, if you are claiming a refund of $150 for the period from January 1 to June 30, submit your claim by July 31.

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If your claim is for $200 or more, you can submit it any time during the year. However, you can only file one claim in any given month. If your refund is for gasoline that you use in different types of vehicles and equipment, you should combine these amounts into one claim. Time limit You have up to two years from the date you purchased the gasoline to claim a refund. For example, if you purchased gasoline on May 31, 1997, submit your application to us before June 1999. Normally we neither request payment nor refund for amounts less than $5. Documents to keep Do not send receipts or other documents with your refund application. However, you must keep documents such as invoices, receipts, or vouchers, and confirmation-of-use statements, since we may ask you for proof that you purchased the gasoline for which you are claiming a refund. Your documents must contain enough information to allow us to verify your gasoline tax refund claim. continue on next page
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Your proof of purchase must include the supplier's name, the buyer's name, the purchase date, and the quantity and price of gasoline purchased. We do not accept estimates for missing records. In addition, we will not accept a receipt made out to "cash" as proof of purchase. You can claim a refund for allowances that you pay your employees and volunteers for vehicle operating expenses for business purposes. You must keep copies of expense account statements that show kilometres and proof of payment to the employee or volunteer. If you send receipts or vouchers to other government departments or agencies, you must keep copies or other written proof to support the refund claim you file with us. You must keep all records and account books in Canada for six years from the end of the year to which they relate. If you are an organization or association, you must keep your books and records at your place of operations in Canada.

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Diversions of gasoline to taxable use If you received an excise gasoline tax refund and you later sell or otherwise divert the gasoline to a use that is not eligible for a refund, the gasoline becomes subject to the full federal excise tax. In this case, you must repay your refund to us. Make your cheque or money order payable to the Receiver General and send it with a written explanation to your tax services office. For more information If you need more information about the program or if you need to order more application forms, please contact your tax services office. You can find the addresses and telephone numbers in the Government of Canada section of your telephone book. If you have questions about an application you have already mailed, you can call us toll free at 1-877-432-5472. You can also write to us at Federal Excise Gasoline Tax Refund, Summerside Tax Centre, Suite 101, 275 Pope Road, Summerside PE C1N 6E7. When you contact us, we will need your identification number, telephone number, the claim period, the date you sent your application, and the amount of your claim.
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Canada Revenue Agency

Agence du revenu du Canada

XE8 (09) PROTECTED when completed

APPLICATION FOR REFUND OF FEDERAL EXCISE TAX ON GASOLINE NOTE: In this form, the text inserted between square brackets represents the regular print information. See page 12 [the back] of this form for instructions on how to complete it. Keep one copy of this form and send one to Federal Excise Gasoline Tax Refund, Summerside Tax Centre, Suite 101, 275 Pope Road, Summerside PE C1N 6E7. A) Identification number B) Language preference English French

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If the details below are different from your previous claim please check this box C) Claimant's last name or name of organization or association

Claimant's first name and initials (not required for organizations or associations) Mailing address

City

Province/Territory

Postal code

Telephone nos. Area code Number ­ continue on next page
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Area code Number or ­

D) Type of claimant ­ check (

) the applicable box

Registered Canadian amateur athletic association Registration number issued by CRA

Registered charity Registration number issued by CRA

Individual with a mobility impairment Are you medically certified as having a permanent mobility impairment to the extent that you cannot safely use public transportation?

Yes

No

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E) Period covered by this claim Year From Month Day To Year Month Day

Important File only one claim for each time period. F) Calculation of refund You can use one or both calculation methods for the same claim period. However, you cannot use both calculations to claim a refund for the same gasoline purchase. Does this claim cover more than one vehicle? Calculation based on number of litres purchased (Round to nearest litre) a) Total litres of eligible gasoline b) Refund rate per litre c) Amount of refund claimed (line a × line b) continue on next page
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Yes

No

$0.015 A

Calculation based on kilometres driven d) Total eligible kilometres claimed e) Refund rate per kilometre f) Amount of refund claimed Total amount of refund claimed Total amount of boxes A and B G) Name and address of any person or firm other than the claimant who prepared this claim Name (line d × line e) $0.0015 B km

Address

City

Province/Territory

Postal code

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Area code Telephone number ­ H) Certification I hereby certify that: the amount claimed or any part of it has not been claimed before; all relevant books, records, and invoices are available for inspection; and the information contained in this claim is true, correct, and complete in every respect. Signature Year Month Day

IT IS A SERIOUS OFFENCE TO MAKE A FALSE APPLICATION

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How to complete this form
Section A -- Identification number
For registered charities and registered Canadian athletic associations, this number is your Business Number that was issued by Canada Revenue Agency (CRA). For individuals, if this is your first claim please indicate by writing "New Claimant" on the top of the application. Your Identification Number will be indicated on your refund. You must quote this number on each subsequent refund claim, on all correspondences and when you contact the Federal Excise Gasoline Tax Refund Unit by telephone.

Section B -- Language preference
Check the applicable box to indicate your language preference.

Section C -- Name and address
Enter the name of your registered charity or registered Canadian athletic association, as registered with CRA, complete the mailing address, and telephone numbers. For individuals the application must be made out in the name of the individual with the mobility impairment.
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Section D -- Type of claimant
Check the applicable box to indicate the type of category for which you are claiming a refund. If you have a mobility impairment, do not send your medical certificate with your application but keep it with your files.

Section E -- Period covered by this claim
Enter the date of the first and last purchase of gasoline covered by this claim.

Section F -- Calculation of refund
The amount of your claim is the total of boxes A and B .

Section H -- Certification
For registered charities and registered Canadian athletic associations, the application must be signed by an authorized representative. Individuals claiming the gasoline refund must sign the application. Unsigned applications will not be processed. continue on next page
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The information on this form is collected for the administration of the Federal Excise Tax On Gasoline Program and is protected under the provisions of the "Privacy Act". The form is stored in Personal Information Bank on the General Public related to the Application for Excise Tax Refund on Gasoline No. RCC PPU 051.

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