ministry of finance application for tobacco retail …...• if there is a change to any of the...

1963E (2018/05) © Queen's Printer for Ontario, 2018 Disponible en français Page 1 of 4

Ministry of Finance 33 King Street West PO Box 625 Oshawa ON L1H 8H9

Application for Tobacco Retail Dealer’s Permit Tobacco Tax Act

Important – Please read the instructions before completing this Application for Tobacco Retail Dealer’s Permit.

InstructionsFor general information visit: https://www.ontario.ca/finance

• For help completing this form, call the Ministry of Finance at 1-866-ONT-TAXS (1-866-668-8297) and when you hear What program are you calling about? respond with Tobacco.

• To register a business number contact Canada Revenue Agency: 1-800-959-5525 or www.cra-arc.gc.ca

• If there is a change to any of the information provided on the Application for Tobacco Retail Dealer’s Permit, it must be reported to the Ministry of Finance.

• To register for a Tobacco Retail Dealer’s Permit please complete this form and mail it to the address below.

• To complete this form, please: • Print clearly.

• Provide all required information. Note that failure to provide all required information may cause a delay in processing your Application.

• Ensure that an authorized person signs the certification: e.g. sole proprietor, partner, officer, director.

• Return the completed Application to: Ministry of Finance 33 King Street West PO Box 625 Oshawa ON L1H 8H9

For the Type of business selected in Section 6, enter the corresponding information for Legal name in Section 9.

Type of business Legal name required for selected business type

Sole Proprietorship First name, middle initial and last name of the owner

General Partnership First name, middle initial and last name of Partners

Corporation Full legal corporate name

Association Full legal name of the association

If your type of business is not listed above, please contact the Ministry of Finance at 1-866-ONT-TAXS (1-866-668-8297).

https://www.ontario.ca/financehttp://www.cra-arc.gc.ca/

1963E (2018/05) Page 2 of 4

Ministry of Finance 33 King Street West PO Box 625 Oshawa ON L1H 8H9

Application for Tobacco Retail Dealer’s Permit Tobacco Tax Act

1. Reason for application

Starting a new business Buying an existing business

Amalgamation Adding a new location

Replacing Retail Sales Tax (RST) vendor permit Change in legal entity

2. If you are starting a new business, buying an existing business or adding a new locationDate business commences under your ownership (yyyy/mm/dd) Previous business closing date (if applicable) (yyyy/mm/dd)

Previous Business Number Previous legal name

Did you purchase tobacco products from previous owners?

Yes No If yes, please enter cost of tobacco products, if known $

3. If you are amalgamatingAmalgamation date (yyyy/mm/dd)

4. Are you a franchise?

Yes No

5. If you are replacing an RST vendor permitRST vendor permit number

6. Type of business

Sole Proprietorship General Partnership Corporation Association


7. Additional business information and identifiers

Do you have any of the following? If Yes, please enter number

Federal Business Number (BN) Yes No

Municipal Tobacco License Yes No

8. If a corporationOntario incorporation number Date of fiscal year end (yyyy/mm/dd) Date of incorporation (yyyy/mm/dd)

Certificate of incorporation number if incorporated outside of Ontario Jurisdiction

9. Legal name (See Instructions for type of name(s) required)

1963E (2018/05) Page 3 of 4

10. Business or Trade name

If the same as Legal name (above) check this box. If not the same, complete below.

If the Trade name is not registered with the Ministry of Government and Consumer Services, please call that ministry at 1-800-361-3223 to register.

11. Business AddressApt./Floor/Unit Number Street Number Street Name

Lot/Concession/PO Box/R.R. Number/Postal Stn. City/Town/Municipality

Province Postal Code Business Telephone Number Email Address

Do you have more than one Ontario business location?

Yes No If yes, attach a list of all locations

12. Mailing Address

If the same as business address (above) check this box. If not the same, complete below.Apt./Floor/Unit Number Street Number Street Name


Province/State Postal/ZIP Code

13. Head Office Address

If the same as business address (above) check this box

If the same as mailing address (above) check this box } If not the same as business or mailing address, complete belowApt./Floor/Unit Number Street Number Street Name



14. Name, title, home phone and home address of the owners, partners, officers, directors, or membersIf there are more than two persons, attach a separate list showing details for each

Last Name First Name Middle Name

Title Home Telephone Number

Home AddressApt./Floor/Unit Number Street Number Street Name



1963E (2018/05) Page 4 of 4

Last Name First Name Middle Name

Title Home Telephone Number

Home AddressApt./Floor/Unit Number Street Number Street Name



15. Person to contact about this ApplicationLast Name First Name Middle Name

Title/Relationship to business (e.g. partner, officer, director, owner, lawyer, accountant, employee, spouse)

Business Telephone Number Home Telephone Number Fax

Cell Pager Toll-free

16. Do you prefer communication in French?

Yes No

17. CertificationI certify that the information on this Application is, to the best of my knowledge, true, correct and complete.

Last Name First Name

Title/Relationship to business (e.g. partner, officer, director, owner, lawyer, accountant, employee, spouse)

Signature Date (yyyy/mm/dd)

If there is a change to any of the information provided on the Application for Tobacco Retail Dealer’s permit, it must be reported to the Ministry of Finance.

Personal information on this form is collected under the authority of the Tobacco Tax Act and will be used for the purposes of registering the applicant and issuing a Tobacco Retail Dealer’s permit. Questions about this collection may be directed to an Agent with the Ministry Information Centre at 1-866-ONT-TAXS (1-866-668-8297) or in writing to the address provided in the instructions.

Application for Tobacco Retail Dealer’s Permit�Instructions�1. Reason for application�2. If you are starting a new business, buying an existing business or adding a new location�3. If you are amalgamating�4. Are you a franchise?�5. If you are replacing an RST vendor permit�6. Type of business�7. Additional business information and identifiers�8. If a corporation�9. Legal name�10. Business or Trade name�11. Business Address�12. Mailing Address�13. Head Office Address�14. Name, title, home phone and home address of the owners, partners, officers, directors, or members�15. Person to contact about this Application�16. Do you prefer communication in French?�17. Certification�

1963E (2018/05) © Queen's Printer for Ontario, 2018

Disponible en français

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1963E (2018/05)

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Application for Tobacco Retail Dealer’s Permit

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Government of Ontario

Ministry of Finance

33 King Street West

PO Box 625

Oshawa ON L1H 8H9


Tobacco Tax Act

Important – Please read the instructions before completing this Application for Tobacco Retail Dealer’s Permit.

Instructions

Instructions

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For general information visit: https://www.ontario.ca/finance

• For help completing this form, call the Ministry of Finance at 1-866-ONT-TAXS (1-866-668-8297) and when you hear What program are you calling about? respond with Tobacco.

• To register a business number contact Canada Revenue Agency: 1-800-959-5525 or www.cra-arc.gc.ca

• If there is a change to any of the information provided on the Application for Tobacco Retail Dealer’s Permit, it must be reported to the Ministry of Finance.

• To register for a Tobacco Retail Dealer’s Permit please complete this form and mail it to the address below.

• To complete this form, please:

• Print clearly.

• Provide all required information. Note that failure to provide all required information may cause a delay in processing your Application.

• Ensure that an authorized person signs the certification: e.g. sole proprietor, partner, officer, director.

• Return the completed Application to:Ministry of Finance33 King Street WestPO Box 625Oshawa ON L1H 8H9

For the Type of business selected in Section 6, enter the corresponding information for Legal name in Section 9.

Type of business

Legal name required for selected business type

Sole Proprietorship

First name, middle initial and last name of the owner

General Partnership

First name, middle initial and last name of Partners

Corporation

Full legal corporate name

Association

Full legal name of the association


.\ontarioLogo\NEW Ont Trillium logo blk.bmp

Government of Ontario

Ministry of Finance

33 King Street West

PO Box 625

Oshawa ON L1H 8H9


Tobacco Tax Act



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2. If you are starting a new business, buying an existing business or adding a new location

2. If you are starting a new business, buying an existing business or adding a new location

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Did you purchase tobacco products from previous owners?

3. If you are amalgamating

3. If you are amalgamating

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5. If you are replacing an RST vendor permit

5. If you are replacing an RST vendor permit

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6. Type of business

6. Type of business

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Do you have any of the following?

If Yes, please enter number

Federal Business Number (BN)

Municipal Tobacco License

8. If a corporation

8. If a corporation

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9. Legal name (See Instructions for type of name(s) required)

9. Legal name

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If the Trade name is not registered with the Ministry of Government and Consumer Services, please call that ministry at 1-800-361-3223 to register.

11. Business Address

11. Business Address

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Do you have more than one Ontario business location?

If yes, attach a list of all locations

12. Mailing Address

12. Mailing Address

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}

If not the same as business or mailing address, complete below

14. Name, title, home phone and home address of the owners, partners, officers, directors, or members

14. Name, title, home phone and home address of the owners, partners, officers, directors, or members

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If there are more than two persons, attach a separate list showing details for each

Home Address

Home Address

15. Person to contact about this Application

15. Person to contact about this Application

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17. Certification

17. Certification

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I certify that the information on this Application is, to the best of my knowledge, true, correct and complete.

If there is a change to any of the information provided on the Application for Tobacco Retail Dealer’s permit, it must be reported to the Ministry of Finance.

Personal information on this form is collected under the authority of the Tobacco Tax Act and will be used for the purposes of registering the applicant and issuing a Tobacco Retail Dealer’s permit. Questions about this collection may be directed to an Agent with the Ministry Information Centre at 1-866-ONT-TAXS (1-866-668-8297) or in writing to the address provided in the instructions.

8.0.1291.1.339988.308172

Application for Tobacco Retail Dealer’s Permit Tobacco Tax Act

MOF

Application for Tobacco Retail Dealer’s Permit  Tobacco Tax Act

Section 2. If you are starting a new business, buying an existing business or adding a new location. Date business commences under your ownership (yyyy/mm/dd).Enter date in format: year: 4 digits, month: 2 digits, day: 2 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard)

Section 2. Previous business closing date (if applicable) (yyyy/mm/dd).Enter date in format: year: 4 digits, month: 2 digits, day: 2 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard)

Section 3. If you are amalgamating. Amalgamation date (yyyy/mm/dd).Enter date in format: year: 4 digits, month: 2 digits, day: 2 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard).

Section 8. Date of fiscal year end (yyyy/mm/dd).Enter date in format: year: 4 digits, month: 2 digits, day: 2 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard)

Section 8. Date of incorporation (yyyy/mm/dd).Enter date in format: year: 4 digits, month: 2 digits, day: 2 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard)

Section 11. Business Address. Postal Code.Enter Postal Code in format: letter, digit, letter, digit, letter, digit.

Section 17. Date (yyyy/mm/dd).Enter date in format: year: 4 digits, month: 2 digits, day: 2 digits. Or select date from the drop down calendar (press down arrow to open the calendar, use the arrow keys to navigate by keyboard)

CurrentPageNumber: NumberofPages: TextField1: initFld: Section 1. Reason for application. Starting a new business.: Section 1. Buying an existing business.: Section 1. Amalgamation.: Section 1. Adding a new location.: Section 1. Change in legal entity.: businessDate: previousDate: Section 2. Previous Business Number.: Section 2. Previous legal name.: Section 16. Do you prefer communication in French? Yes. : Section 16. Do you prefer communication in French? No.: Section 2. Did you purchase tobacco products from previous owners? If yes, please enter cost of tobacco products, if known. $: startDate: Section 5. If you are replacing an RST vendor permit. RST vendor permit number.: Section 6. Type of business. Sole Proprietorship.: Section 6. Type of business. General Partnership.: Section 6. Type of business. Corporation.: Section 6. Type of business. Association: Section 7. Do you have any of the following? Federal Business Number (BN). If Yes, please enter number.: Section 7. Do you have any of the following? Municipal Tobacco License. If Yes, please enter number.: Section 8. If a corporation. Ontario incorporation number.: fiscalDate: incorpDate: Section 8. Certificate of incorporation number if incorporated outside of Ontario.: Section 8. Jurisdiction.: Section 10. Business or Trade name.: Section 10. Business or Trade name. If the same as Legal name (above) check this box. If not the same, complete below.: Section 14. Home Address 2. Apartment/Floor/Unit Number.: Section 14. Home Address 2. Street Number.: Section 14. Home Address 2. Street Name.: Section 14. Home Address 2. Lot/Concession/PO Box/Rural Route Number/Postal Station.: Section 14. Home Address. 2. City/Town/Municipality.: Section 14. Home Address 2. Province/State.: Section 14. Home Address 2. Postal/ZIP Code.: Section 14. Home Telephone Number.: Section 11. Email Address.: Section 13. Head Office Address. If the same as business address (above) check this box.: Section 13. If the same as mailing address (above) check this box.: Section 17. Certification. Last Name. : Section 17. First Name.: Section 15. Middle Name. : Section 17. Title/Relationship to business (e.g. partner, officer, director, owner, lawyer, accountant, employee, spouse): Section 15. Business Telephone Number.: Section 15. Home Telephone Number.: Section 15. Fax.: Section 15. Cell.: Section 15. Pager.: Section 15. Toll-free.: Section 17. Signature.: date: Print: Reset:

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