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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
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