Government of Ontario: Ministry of Transportation

Application for Garage Licence

Office Use Only Office No. Fee $
Licence No.
Original Replacement
Date (yy/mm/dd)

Applicant Last Name
First Name
Middle Name Initial
Name of Firm or Ass.
Business or Trade Name

Business Address Street No. Street Name
Lot/Part/Block/Section
Concession & Twp.
City, Town or Village
Postal Code
Region, County
Name of previous operator at this address

Class of Licence Required A Dealing in Trailers
C Buying for Wrecking
Motor Vehicle Dealers Act Registration No.

No person shall carry on business as a motor vehicle dealer unless he is registered under the Motor Vehicle Dealers Act.

Certificate of Insurance

I hereby certify that I am in compliance with municipal by-laws with respect to my business and the premises described on this application and that I am insured under the standard garage automobile policy made with:

Name of Insurance Company

Policy No.

Signature

Date (Y/M/D)

Every person who makes a false statement or includes inaccurate information in a written or electronic application, declaration, affidavit or other document required by this Act, the regulations or the Ministry, is guilty of an offence and on conviction, in addition to any other penalty or punishment to which the person may be liable, is liable to a fine of not less than $400 and not more than $5,000 or to imprisonment for a term of not more than 30 days, or to both, and in addition the person’s driver’s licence or vehicle permit may be suspended for a period of not more than six months.

Version française disponible

SR-LV-053E (2022/11)