Satellite Internet Service Rebate Program

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Welcome to the Satellite Internet Service Rebate application.

To submit your application electronically, please complete the form below. To submit your application via mail and for non-Canadian residents, please contact Develop Nova Scotia at 1-800-298-2854 or satellite@developns.ca Instructions for Completing Sections A and B: • If you are an individual, complete Section A only. • If you are applying for an incorporated business, complete Section B only. • If you are a sole proprietor, complete Sections A and B.

Section A: Personal information for individuals and sole proprietorships

Complete this section if you are an individual or sole proprietor. This information is required by the Nova Scotia Internet Funding Trust for reporting requirements to the Canada Revenue Agency. The rebate is paid in the form of a capital distribution to a Consumer Beneficiary as defined in the Nova Scotia Internet Funding Trust indenture, as amended from time to time. Generally, for residents of Canada, this rebate is not considered taxable income if you are not carrying on a business or earning income from property, however, you should consult your own tax advisor or Canada Revenue Agency for any specific tax related questions.

First name

Middle Initial

Last name

Phone

Social insurance number

Date of Birth (mm/dd/yyyy)

Section B: Business information for corporations and sole proprietorships

Complete this section for an incorporated business or sole proprietorship. This information is required by the Nova Scotia Internet Funding Trust for reporting requirements to the Canada Revenue Agency. The rebate is paid in the form of a capital distribution to a Consumer Beneficiary as defined in the Nova Scotia Internet Funding Trust indenture, as amended from time to time. Generally, this rebate is considered taxable income to the extent it is received in the context of carrying on a business or earning income from property, however, you should consult your own tax advisor or Canada Revenue Agency for any specific tax related questions.

Legal business name

The name on the business registration

Operating name

Canada Revenue Agency business number

Business contact name

For example, John Smith

Contact job title

Contact email

Contact phone

Section C: Satellite Service Information

Complete this section about your satellite service. The address entered must be a qualified address otherwise your application will be rejected. To ensure your address is qualified please visit https://internet.developns.ca/satellite Qualified satellite service providers must meet or exceed CRTC minimum speed targets of 50 Mbps download / 10 Mbps upload. For information on currently eligible satellite service providers, please visit https://internet.developns.ca/satellite

Satellite Service Provider

Service Street address

Service City/Town

Service Province

Service Postal code

For example, A1A A1A

Section D: Upload proof of purchase

Your application must include proof of purchase of the satellite internet service indicated in Section C.

Upload document

Accepted file types: doc, docx, jpg, jpeg, pdf

Maximum file size per file: 10 MB

Section E: Mailing address

The Nova Scotia Internet Funding Trust issues rebates via cheque. Provide a complete mailing address for your rebate cheque.

Mailing street address

Mailing city/town

Mailing province

Mailing postal code

For example, A1A A1A

Attestation

I certify that the information provided in this application is, to the best of my knowledge and ability, complete, true and correct, and that this will apply to all information provided in the future in connection with the assessment of this application. Furthermore, I will promptly notify Develop Nova Scotia (the Program Administrator) if any of the information changes.

Yes