Change of Address - Ontario · Change of Address. Effective Date of Change (mm/ dd / yyyy) Contact...

2001E (2015/09) © Queen's Printer for Ontario, 2015 Disponible en français

Ministry of Finance

33 King Street W PO Box 627 Oshawa ON L1H 8H5

Change of AddressEffective Date of Change (mm / dd / yyyy)

Contact InformationLegal / Trade Name

Care of

New Address Yes No ChangeUnit Number Street Number Street Name PO Box

City / Town Province / State Postal / Zip Code

Country Telephone Numberext.

Fax Number

New Mailing Address Yes Same as Above No ChangeUnit Number Street Number Street Name PO Box

City / Town Province / State Postal / Zip Code

Country Telephone Numberext.

Fax Number

Please select each ministry program affected by your address change

Ministry Program Business / Identification /Reference Number

Employer Health Tax

Provincial Land Tax

Gasoline Tax

Fuel Tax

Tobacco Tax

IFTA (International Fuel Tax Agreement)

Mining Tax

Estate Administration Tax

Corporations Tax

Ministry Program Business / Identification /Reference Number

Retail Sales Tax

Wine Tax

Beer Tax

Hydro PIL Tax

Debt Retirement Charge

Gross Revenue Charge

Premium Tax

Race Tracks Tax

SignatureI certify that the information provided is, to the best of my knowledge, true, correct and complete.

Last Name of Authorized Person First Name of Authorized Person

Title Signature Date (mm / dd / yyyy)

Email Address

Enquiries Toll Free 1 866 ONT-TAXS (1 866 668-8297)

Teletypewriter (TTY) 1 800 263-7776

Website www.ontario.ca/finance