39 Forms found for example-of-a-medical-license-number

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  • on00489
    Application for a Licence to Operate a Supply Facility under s. 4 of the Animals for Research Act

    A License is needed if you wish to operate a supply facility. Supply facility means premises that are used for breeding and rearing of animals to be used in research, teaching or testing. Please complete this application for a license to operate a supply facility under the Animals for Research Act. A license expires on the 31st day of December of the year of issue. Licenses must be renewed annually. A separate application and payment of fees is required for each supply.
  • 011-0027
    Application for Ontario's Home Energy Audit Grant (Program)

    Application Form for entry into the Ontario Home Energy Audit Program for Corporate Owned Residential Properties. Homeowners are required to complete this form with a licensed Energy Advisor during their home energy audit to be eligible for an audit grant. For more information, visit www.ontario.ca/homeneergy
  • 011-0022
    Application for Ontario's Home Energy Audit Grant (Program)

    Application Form for entry into the Ontario Home Energy Audit Program. Homeowners are required to complete this form with a licensed Energy Advisor during their home energy audit to be eligible for an audit grant. Please visit the program website at www.ontario.ca/homeenergy for more information.
  • on00817
    Northern Health Travel Grant Application Online form

    Online application form used to apply for financial travel assistance by Northern Ontario residents who must travel long distances to access medical specialist services.
  • 012-1987
    Well Contractor Licence Application - Form 1

    This form is for individuals/businesses interested in applying for a new Well Contractor Licence, which is required by anyone engaging in the business of well construction, and expires on March 31 each year following the year of issue. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • 012-1993
    Well Technician Licence Application - Form 4

    This form is for individuals interested in applying for a new Well Technician Licence or to add-a-class(es) to their existing Well Technician Licence, The licence is required to work at the construction of wells and expires on March 31 following the year of issue. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • on00195
    Application for a New Licence for the Operation of a Dairy Plant The Milk Act (R.S.O. 1990, c.M12), and Regulations 761

    A new licence is required prior to beginning the operations of a dairy plant including: When a facility is being licensed for the first time. When an existing licensed plant is transferred to a new owner (transfer of ownership) An "Application for a Permit to Construct or Alter a Building Intended for Use as a Dairy Plant – For New Applicants" must be submitted at the same time as an “Application for a Licence for the Operation of a Plant”. Note, the licence will not be issued until the plant is complete and the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) has confirmed, through inspection, that it meets all applicable regulations under the Milk Act (Ontario).
  • on00350
    Special Sales Licence Application Livestock Community Sales Act

    A licence is required to carry out the community sales of consigned livestock in Ontario. This applies to an operator licensed for Class 1 or Class 2 community sales to hold an extra community sale not authorized by the licence for Class 1 or Class 2 community sales.
  • 012-1995
    Application for Assistant Well Technician Identification Card - Form 8

    This form is for licensed well contractors and their assistant technicians (not sooner than after four months of employment with the well contractor) interested in applying for or renewing an Assistant Well Technician Identification Card, which expires 36 months following the date of issue. Ontario Regulation 903 prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • 003-atdia-003
    Notice of Transfer of a Machine

    When a tile drainage machine changes ownership, the Regulations under the Agricultural Tile Drainage Installation Act requires that a notice of transfer of a machine must be completed and submitted within ten days after the transfer occurs. Where the machine is already licensed, this licence will be transferred to the new owner.
  • on00581
    Voluntary Surrender of a Meat Plant Licence

    A licensee of a provincially licensed meat plant may voluntarily surrender their meat plant licence if they no longer conduct regulated activities.
  • 003-atdia-004
    Application For a Business Licence (Licence to Install Drainage Works)

    To obtain a new business licence, the Regulations under the Agricultural Tile Drainage Installation Act indicate that all businesses must employ a least one Class “A” operator and have access to one licensed machines. To issue a new business licence, an inspection of your operation will be necessary. All business licences are issued for a one-year term expiring March 31; the fee for this licence is $250.00.
  • 012-1990
    Application for an Appointment to Take an Examination - Form 7

    This form is for all new applicants for a Well Contractor or a Well Technician Licence. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • 012-1988
    Well Contractor Licence Renewal Application - Form 3

    This form is for Well Contractors Licence holders who wish to renew their licence; which expires on March 31 following the year of issue; and is required by anyone engaging in the business of well construction. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • on00314
    Request for Prior Approval for Full Payment of Insured Out-of-Country (OOC) Health Services

    This form is meant to be submitted by a practicing Ontario physician on behalf of their patients to request consideration of funding for out-of-country health services. Along with the completed application form, submissions must also include relevant medical documentation.
  • on00583
    Application for a Non-Shopkeeper- Distributor Licence

    You must hold a non-shopkeeper distributor licence if you meet at least one of the following: • You sell or distribute fluid milk products and do not operate a shop. • You operate a shop and less than 50% by volume of your fluid milk products are sold directly to consumers from your shop. • You are a fluid milk distributor and you don’t buy your milk products from a licensed non-shopkeeper distributor. Licences are issued for a period of up to 3 years and must be renewed before the expiry date stated on the licence.
  • on00785
    Well Evaluation Private Gas Well

    This form is used to collect details about the private well, completed by a Qualified Person. A complete submission includes: - Well Evaluation Form - Well Location Sketch - Ownership documentation - Four photos of the well from N, S, E, W.
  • 013-3446
    Application for Refund - Summary Loss of Product (PRL)

    Used by beer vendors in Ontario (e.g., licensed establishments) who paid amounts on account of the beer tax on beer made by Ontario beer manufacturers that was stolen, destroyed (e.g., by fire), or lost (e.g., vehicle accident) prior to the sale of the beer to purchasers. This does not apply to purchases from or through the Liquor Control Board of Ontario.
  • 012-1989
    Well Technician Licence Renewal Application - Form 6

    This form is for Well Technician Licence holders who wish to renew their licence, which expires on March 31 following the year of issue. A Well Technician Licence of the proper prescribed class(es) is required to work at the construction of wells. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.