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1155E

This document is a sworn statement for transferring a used vehicle between parties in Ontario. It requires the recipient and donor to provide details of the vehicle transfer, including their names and addresses, vehicle details like year, make, model and VIN number, and the date and reason for the transfer. They must swear to the accuracy of the information before a commissioner, and are warned that providing false information is punishable by law. The statement collects information to determine eligibility for retail sales tax exemption on the used vehicle transfer.

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Geoff
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315 views

1155E

This document is a sworn statement for transferring a used vehicle between parties in Ontario. It requires the recipient and donor to provide details of the vehicle transfer, including their names and addresses, vehicle details like year, make, model and VIN number, and the date and reason for the transfer. They must swear to the accuracy of the information before a commissioner, and are warned that providing false information is punishable by law. The statement collects information to determine eligibility for retail sales tax exemption on the used vehicle transfer.

Uploaded by

Geoff
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Ministry of Finance

Retail Sales Tax


Sworn Statement for the Transfer of a
33 King Street West
PO Box 623
Used Vehicle in the Province of Ontario
Clear Form Oshawa ON L1H 8H7

TO WIT:

Under the Retail Sales Tax Act, R.S.O. 1990, c.R.31 (as amended), clause 4.2(4) (a)(b)(c)(e), 4.2(8), 8(2), and Regulation
1013 Section 13 of Revised Regulations of Ontario, 1990 made under the Retail Sales Tax Act, as amended.

We, of the of
(Name of Recipient) (City, Town, etc.) (Name of City, Town, etc.)

in the of , Province of Ontario, and


(County, Regional Municipality, etc.) (Name of County, Regional Municipality, etc.)

of the of
(Name of Donor) (City, Town, etc.) (Name of City, Town, etc.)

in the of , Province of Ontario,


(County, Regional Municipality, etc.) (Name of County, Regional Municipality, etc.)

MAKE OATH AND SAY:

1. We have personal knowledge of the matters stated below.


2. The Recipient is now the owner of the Used Vehicle(s) named in the Application(s) for Transfer.
3. The Used Vehicle(s) owned by the said Recipient is/are a
(year) (make) (model)
bearing Vehicle Identification Number .
If more than 1 vehicle is being transferred attach list including Year, Make, Model and VIN Number.
4. The Used Vehicle(s) was/were acquired by the said on
(Name of Owner/Recipient) (Date)
from as the result of
(Name of Donor) (Reason(s))
5. The detailed reason(s) for the transfer of the Used Vehicle(s) was/were

SWORN before me
at the of )
(City, Town, etc.) (Name of City, Town, etc.)
)
in the of ) (Signature of Recipient)
(County, Regional Municipality, etc.) (Name of County, Regional Municipality, etc.)
)
this day of
(month) (year) )
(Signature of Donor)
)
)
* A Commissioner, etc. )
) * Commissioner may be:
Lawyer/Notary Public
Note: When claiming an exempt transfer of used vehicles between Justice of the Peace
Corporations, or between a Corporation and Shareholder, attach to the Local municipal/town Clerk, Deputy Clerk, Treasurer, Head of Municipal
sworn statement an information Addendum which may be Council, Reeve/Deputy
obtained from the ServiceOntario Centre/Driver and Vehicle License Others appointed by Lieutenant Governor to administer oaths and to take
affidavits (call 1 866 668-8297 for availability of a Commissioner)
Issuing Office.

WARNING: Every person who knowingly makes a false or deceptive statement herein is guilty of an offence and is liable on conviction to
a fine, or term of imprisonment, or both (Retail Sales Tax Act, Subsections 32(4) and 32(4.1)).

Personal information is collected on this form under authority of subsection 4.2(8) of the Ontario Retail Sales Tax Act, R.S.O. 1990, c.R.31, (as amended)
and may be used to determine eligibility for retail sales tax exemption. Questions about this collection should be directed to:
Ministry of Finance, 33 King Street West, PO Box 623, Oshawa ON L1H 8H7, 1 866 668-8297.
1155E (2014/06) © Queen’s Printer for Ontario, 2014 Disponible en français Print Form

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