Form A Transaction Record - Metal Dealers And Recyclers Regulation
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1Form A - Transaction Record
Metal Dealers and Recyclers Regulation
METAL DEALER/RECYCLER INFORMATION
Name of metal dealer/recycler:
Registration number:
___________________________________________________________________________________
Address
:
_______
_________________
: ___________________________
Prov:
Postal Code:
Phone number (include area code)
Date of transaction:
Total value of transaction:
:
Time of transaction
Full name of employee completing the transaction:
IDENTIFICATION INFORMATION OF PERSON PRESENTING METAL
Full Name as recorded on the identification:
Identification presented:
Driver’s licence number or
Province/state issuing driver’s
Driver’s licence:
identification card number:
licence:
BC identification card:
Note: ID must have photograph of the person.
Customer Code:
Customer code is the first three letters of the person’s surname and the last three numbers, letters or characters as it appears on the identification.
For example: John Tucker’s BC DL # 1234567 would be coded as “TUC567”.
SELLER INFORMATION
________________________________________________ _____________________________________
Name:
_______________________________________________________
_______
_______
Address:
Prov:
Postal Code:
_________________________________________________________________
Phone number (include area code):
IF DELIVERER OF THE METAL IS NOT THE OWNER
_____________________________________________________________________________________
Name:
_______________________________________________________
_______
_______
Address:
Prov:
Postal Code:
_________________________________________________________________
Phone number (include area code):
DESCRIPTION OF VEHICLE USED DELIVERING THE METAL
____________ __________ ___________ ____________ ____________
Make
Model
Colour
Plate Number
Province/State
DESCRIPTION OF METAL PURCHASED
Description of predominant metal: (e.g. copper pipes ½ inch outer diameter, aluminum house siding etc.)
Institute of Scrap Recycling
Distinguishing marks or features of metal (if any):
Industries (ISRI) Code(s):
Weight (kg):
Origin of metal stated by seller:
DESCRIPTION OF PROOF OF OWNERSHIP OF METAL:
(required if metallic wire with insulation or casing removed or metal with identifying marks
presented)
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Parent category: Business