Government of Ontario: ServiceOntario

Application for Special Permit (Permit Valid For 10 Days)










Buyer is responsible to notify the ministry within six days of a change of ownership of this vehicle.

Reason for Application





Vehicle Information

Vehicle Type

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It is an offence to apply for a Special Permit for a vehicle that is in an unfit status. The fee paid for a Special Permit is non-refundable.





Certificate of Insurance (The Compulsory Automobile
Insurance Act)

I hereby certify that the motor vehicle described above is insured under a contract of automobile insurance made with:









It is a serious offence to make a false statement on this form.

Office Use Only











Method of Payment




Identification Viewed



Information in this form is collected under the authority of the Highway Traffic Act, s. 205, and is used to evaluate the eligibility of the applicant to obtain the Special Permit. If you have any questions about the collection and use of your personal information collected on this form, please call the Supervisor, ServiceOntario, at 416 235-2999 or 1 800 387-3445 or write to the Supervisor, Ministry of Transportation, Licensing Administration Office, Main Floor, Building A, 1201 Wilson Ave., Downsview ON M3M 1J8. Direct general inquiries to ServiceOntario at 416 235-2999, 1 800 387-3445 or visit ServiceOntario.ca.