The following Ontario Retail Sales Tax Exemption Certificate in provided for your convenience. Please print out the form, fill it in, sign it and, fax it to us at (613)646-7382

ONTARIO RETAIL SALES TAX
BLANKET PURCHASE EXEMPTION CERTIFICATE
Blanket [___] 

(Please check box if this is to be kept for 4 yrs. and purchases refer to this certificate)

This certificate is invalid unless fully completed and it expires at the end of four years from the date of issuance. This certificate must be fully completed by the purchaser and sent to the supplier when the purchaser claims an exemption. 

Under the provision of The Ontario Retail Sales Tax Act, I/We hereby claim exemption from tax on the following goods or taxable services, contracts of insurance of benefits plan:


Print or Type






Business Name:



Print or Type
Business Address:


Print or Type
Vendor Permit Number (if applicable):


Nature of Business:


Print or Type


Signature of Purchaser or Authorized Official
Date of Issue




Every person who makes a false statement on a Purchase Exemption Certificate or misuses this certificate is liable if convicted to a fine of not less than $500 plus an amount of not more than double the amount of the tax that should have been paid, or the imprisonment for a term of not more than two years,or both.
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