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Important
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| The person
buying the goods or taxable service, or entering into a contract of insurance
or benefits plan for which an exemption is claimed must complete this
certificate and give it to the supplier. |
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The supplier is
to keep this form as stated in the regulations. This certificate is
valid for your years if,
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a)
The box beside the word "blanket" at the top of the form is
checked; and
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b)
The purchase order refers to this Purchase Exemption Certificate
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Every person who
makes a false statement on a Purchase Exemption Certificate or misuses
the certificate is liable, if convicted, to a fine of not less than
$ 500 and an amount of not more than double the amount of the tax that
should have been paid, or that was evaded, or to imprisonment for a
term of not more that two years, or to both.
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| "Rubber
Stamp" Certificate |
| A "rubber
stamp" certificate in the following form may be imprinted on each
purchase order: |
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Ontario
Retail Sales Tax
Purchase
Exemption Certificate
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| I claim
exemption from Ontario retail sales tax on the contracts of insurance
or benefits plan or on the purchase of the goods and taxables services
ordered on this purchase order. |
Vendor Permit No. (if applicable)
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Signature of Authorized
Person |
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(Print)
Name of Authorized Person
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Blanket
Purchase Exemption Certificate Reference
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| If a
blanket Purchase Exemption Certificate is given to your supplier, a reference
to the certificate in the following form must be imprinted on your purchase
orders: |
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Ontario
Retail Sales Tax
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| The contracts
of insurance or benefits plan or the goods and taxable services ordered
on this purchase order are covered by a blanket Purchase Exemption Certificate
in the name of : |
| Business
Name: |
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| Business
Address: |
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Vendor Permit No (if applicable)
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Signature of Authorized Person
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(Print) Name of Authorized Person
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