Ontario Retail Sales Tax Purchase Exemption Certificate

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.
The supplier is to keep this form as stated in the regulations. This certificate is valid for four years if,
a) the box beside the word “blanket” at the top of the form is checked; and
b) the purchase order refers to this Purchase Exemption Certificate
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 $1,000 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 than two years, or
to both.

Blanket:
Your Name:
Your Email:
Business Name:
Business Address:
Vendor's Permit Number:
Reason for claiming exemption:
I claim exemption from Ontario Retail Sales Tax under the provisions of the Retail Sales Tax Act, on the following goods
Taxable Goods:
Signature of Authorized Person: If you are unable to paste your signature, then please print out and mail hard copy within 7 days, otherwise sales tax will be charged back to you.
Name of Authorized Person
IMPORTANT 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. The supplier is to keep this form as stated in the regulations. This certificate is valid for four years if, a) the box beside the word “blanket” at the top of the form is checked; and b) the purchase order refers to this Purchase Exemption Certificate 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 $1,000 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 than two years, or to both.