Ontario Retail Sales Tax Purchase Exemption Certificate Page 2

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“RUBBER STAMP” CERTIFICATE
A “rubber stamp” certificate in the following form may be imprinted on each purchase order:
ONTARIO RETAIL SALES TAX
PURCHASE EXEMPTION CERTIFICATE
I claim exemption from Ontario retail sales tax on the contracts of insurance or benefits plan or on the
purchase of the goods and taxable services ordered on this purchase order.
Vendor Permit No. (if applicable)
Signature of Authorized Person
Business Name
(Print) Name of Authorized Person
BLANKET PURCHASE EXEMPTION CERTIFICATE REFERENCE
If a blanket Purchase Exemption Certificate is given to your supplier, a reference to the certificate in the
following form must be imprinted on your purchase orders:
ONTARIO RETAIL SALES TAX
The contracts of insurance or benefits plan or the goods and taxable services ordered on this purchase
order are covered by a blanket Purchase Exemption Certificate in the name of:
Business Name: _____________________________________________________________
Business address: ___________________________________________________________
_________________________________
_________________________________
Vendor Permit No. (if applicable)
Signature of Authorized Person
_________________________________
(Print) Name of Authorized Person

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