F.o.t. Application 5a/fuel Oil Tax Act/purchase Of Fuel Oil Tax Exempt/for Commercial Activity-Off-Road Use Only Form

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F .O.T. APPLICATION 5A
FUEL OIL T AX ACT
Finance
PURCHASE OF FUEL OIL T AX EXEMPT
FOR COMMERCIAL ACTIVITY - OFF-ROAD USE ONLY
COMMERCIAL ACTIVITY
(please circle applicable commercial activity and attach supporting documentation)
Activity Type
Supporting Documentation
A - Farming
- Current Property Assessment
F - Fishing
- Commercial Fishing Licence
L - Logging
- Timber Permit
M - Mining
- Claim Documents or Water Licence
H - Outfitting
- Outfitting Operating Certificate
S - Sawmill
- Business Licence
T - Trapping
- Trapping Licence
W - Tourism
- Wilderness Tourism Licence
1. Name of applicant
__________________________________
(legal name of business organization, proprietor or partners)
______________________________________________________________________________________________________
2. Registered trade name – if applicable
_________________________________________________
(Doing Business As)
3. Activity location, size and product ____________________________________________________________________
4. Operating season
from ______________________________ to __________________________________
(in months)
5. Mailing address of activity location ___________________________________________________________________
______________________________________________________________________________________________________
6. Permanent address
__________________________________________________________________
(if different from 5)
______________________________________________________________________________________________________
7. Telephone ________________________ Fax __________________________Email _____________________________
8. Details of off-road equipment used in eligible commercial activity
(Briefly describe the purpose of each piece of off-road equipment; attach another list if more space is required.)
ANTICIPATED
CONSUMPTION
FUEL TYPE:
MAKE/MODEL/YEAR
SERIAL NUMBER
Gas or Diesel
OF FUEL (LITRES)
PER SEASON/YEAR
1.
Purpose:
2.
Purpose:
3.
Purpose:
4.
Purpose:
5.
Purpose:
6.
Purpose:
7.
Purpose:
8.
Purpose:
Formulaire disponible en français
YG(3161EQ)F2 Rev 02/2013

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