Application for MTO Exempt Dealer Program

Application for MTO Exempt Dealer Program
Ministry of
Transportation
This application form must be completed by dealers exempt from the Motor Vehicle Dealers Act, 2002 (MVDA, 2002), in order to qualify for MTO
Highway Traffic Act (HTA) dealer exemptions.
Company Name
HST/GST Number
Operating as
Unit Number
Street Number
Street Name
PO Box
City/Town
Province
Postal Code
Last Name, First Name and Middle Initial or Company Name
Telephone Number
Fax Number
Email Address (if available)
State current/previous
OMVIC Dealer Number
Expiry Date (yyyy/mm/dd)
Please indicate under which category your organization is seeking exemption from the MVDA, 2002
Heavy Truck Dealer - trades, finances or leases exclusively in vehicles with a manufacturer’s gross vehicle weight rating (including trailer) of over
21 tonnes (paragraph 18, O .Reg. 333/08, s.2(1))
Bus or Commercial Motor Vehicle Dealer - trades, finances or leases exclusively in buses or commercial vehicles (e.g. hearses, ambulances) as
defined in the HTA, provided they do not trade with customers who are individuals acting for personal or family use (paragraph 19, O .Reg. 333/08,
s.2(1))
Vehicle Manufacturer or their authorized distributor (paragraph 21, O .Reg. 333/08, s.2(1))
I declare that the above named company meets the requirements for exemption from the MVDA, 2002, and is eligible for the MTO Exempt Dealer Program
by virtue of the above noted regulation. The above named company does not deal in any other vehicles that do not fit into the description(s) above.
I consent to MTO sharing information contained on this application form with the Ontario Motor Vehicle Industry Council (OMVIC), and receiving
information from OMVIC, to confirm eligibility for exemptions under the MVDA, 2002.
Applicant's Signature
Date (yyyy/mm/dd)
Under provincial legislation, the penalty for making a false statement may include a fine and/or imprisonment and/or a cancellation of program membership.
Note
•
Please be advised that you must inform MTO in writing, within five business days, of any change in your business activities that may affect your
eligibility for exemption and participation in the MTO Exempt Dealer Program.
•
MTO reserves that right to revoke status under the MTO Exempt Dealer Program. Dealers must ensure that they inform OMVIC of their
participation in the MTO program, as MTO does not have the authority to cancel OMVIC registrations on behalf of a dealer.
•
Completed applications must be sent to:
Mail: Ministry of Transportation
Vehicle Programs Office
145 Sir William Hearst Avenue
Toronto, ON M3M 0B6
Telephone: 416 235-4461
Fax: 416 235-4821
Email: [email protected]
Office Use Only
MTO Exempt Dealer Program requirements met.
MTO Exemption Number
MTO Exempt Dealer Program requirements not met.
Reviewed by
Date (yyyy/mm/dd)
Approved by
Information in this form is collected under the authority of the Highway Traffic Act. If you have any questions about the collection and use of your
personal information collected on this form, please call the Supervisor, ServiceOntario at 416 235-2999 or 1 800 387-3445 or write to the Supervisor,
Ministry of Transportation, Licensing Administration and Support Office, 87 Sir William Hearst Ave, Toronto, ON M3M 0B4. Direct general inquiries to
ServiceOntario 416 235-2999 or 1 800 387-3445 or visit www.ServiceOntario.ca.
Once completed, this form has a sensitivity level of low.
05017E (2016/02)
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