Safety Standards and Inspection Stickers Order Form

Safety Standards and Inspection
Stickers Order Form
Ministry of Transportation
Motor Vehicle Inspection Station (MVIS) Unit
Instructions
Complete and send to:
The Ministry of Transportation
MVIS Unit
301 St. Paul Street, 8th Floor
St. Catharines ON L2R 7R4
Fax 905 704-2574
Please allow four to six weeks for delivery.
For additional information please visit our website www.mto.gov.on.ca or call 416 246-7166, ext 6308 or 1 800 387-7736, ext 6308.
Station Details
Licensee Name
MVIS Licence Number
Station Address
Unit/Apt/Suite Number
Street Number
Street Name
Lot Number
Concession
Township
City/Town/Village
Postal Code/Zip Code
Country
Province
PO Box
Order Information
Number of books
Price per book ($)
Total Fee ($)
Safety Standards Certificates (20 per book)
Annual Inspection Certificates and Stickers (10 per book)
Semi-Annual Inspection Certificates and Stickers (10 per book)
Total
$
Method of Payment
All personal cheques must be certified unless payment is sent by mail
Amount ($)
Cheque
Make payable to the "Minister of Finance/MTO".
Please note that we do not accept post dated cheques.
Please fill in and attach the Credit Card Authorization
Form (SR-LV-034).
Amount ($)
Stored Credit
Amount ($)
Credit Card
Amount ($)
Certified Cheque
Make payable to the "Minister of Finance/MTO".
Amount ($)
Money Order
Make payable to the "Minister of Finance/MTO".
Amount ($)
Prepaid Account
Signature
Name of Licensee/Representative/Service Provider
Signature of Licensee/Agent/Representative/Service Provider
Date (yyyy/mm/dd)
Print Form
SR-E-209E (2015/05)
© Queen's Printer for Ontario, 2015
Disponible en français
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