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

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  • 014-4900-85
    Physician Affiliation Authorization and Declaration of Professional Standing for ICHSCs

    The form is used to confirm a physician's qualifications to provide the requested services prior to processing a request to affiliate to a particular ICHSC. The licensee must ensure that the physician has been affiliated to the centre before they begin to provide licensed services.
  • on00722
    Application to Surrender an Aggregate Licence or Aggregate Permit under the Aggregate Resources Act

    The Aggregate Resources Act (ARA) provides for the transfer of a licence or permit. A transferred licence or permit will allow the continued operation of the licensed or permitted site under the same terms, conditions and site plan requirements as the original licence or permit. Any changes or amendments to the site plan or licence/permit conditions are a separate process.
  • 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.
  • on00617
    Change of Licence Type Application Form for Security Guard and/or Private Investigator Agency Licence - Sole Proprietorship

    This application is to be used by licensed Security Guard or Private Investigator Agencies (Sole Proprietorship) to apply to change their current licence type with the Private Security and Investigative Services Branch (PSISB). Instructions on how to successfully complete the application are included with the form.
  • on00618
    Change of Information Application Form for Security Guard and/or Private Investigator Agency Licence - Corporation or Partnership

    This application is to be used by licensed Security Guard and/or Private Investigator Agencies (Corporations and Partnerships) to change their information (e.g., update head office and/or mailing address, update/add/remove directors, officers or partners etc) with the Private Security and Investigative Services Branch (PSISB).
  • on00619
    Change of Information Application Form for Security Guard and/or Private Investigator Agency Licence - Sole Proprietorship

    This application is to be used by licensed Security Guard and/or Private Investigator Agencies (Sole Proprietorship) to change their information (e.g., update head office and/or mailing address, Sole Proprietor contact information etc.) with the Private Security and Investigative Services Branch (PSISB). Instructions on how to successfully complete the application are included with the form.
  • on00616
    Change of Licence Type Application Form for Security Guard and/or Private Investigator Agency Licence - Corporation or Partnership

    This application is to be used by licensed Security Guard or Private Investigator Agencies (Corporation or Partnership) to apply to change their current licence type with the Private Security and Investigative Services Branch (PSISB). Instructions on how to successfully complete the application are included with the form.
  • on00544
    Irrevocable Standby Letter of Credit

    A letter of credit is a formal written promise made by a financial institution to pay money to a third party. This template is to be used in the context of temporary help agency and recruiter licensing under the Employment Standards Act, 2000.
  • 2002
    Notice of Lead Exceedance Test Results in Plumbing - Municipal Residential and Non-Municipal Year Round Residential Drinking Water Systems (O. Reg 170/03 Schedule 15.1)

    In accordance with the Drinking Water Systems Regulation (O. Reg 170/03), Schedule 15.1, the following drinking water systems are required to take plumbing and distribution samples and to have the samples tested for Lead by a licensed laboratory: • Large Municipal residential systems • Small Municipal residential systems • Non-municipal year round residential systems.
  • 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.
  • on00431
    Burial Site Discovery: Frequently Asked Questions (FAQs) for Archaeologists

    Investigation of burial sites under Ontario’s Funeral, Burial and Cremation Services Act, 2002 - a guide for licensed archaeologists
  • 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.
  • on00784
    Private Gas Well Licence Application

    This Application for a Well Licence, under the policy "Approach to Licensing Private Gas Wells", is used to apply for a licence for an existing, operating private gas well in Ontario. A complete submission includes: - Well Evaluation Form - Private Gas Well Licence Application Form - Well Location Sketch: Existing Private Gas Well
  • 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.
  • 018-fw1021
    Application for a Licence to Transport Live Fish Taken from Ontario Waters

    A licence to Transport Live Fish is issued under authority of the Fish and Wildlife Conservation Act and is required to transport live fish or live spawn, other than baitfish, that have been taken from Ontario waters. This form allows an individual to apply for this licence. May be used to approve transport of live fish for the purposes of a fishing competitive event. Fish are then transported back into the originating lake. Issued for discrete dates and locations. Licence conditions may include holding tank water condition requirements, release of fish, record keeping requirements, record productions, among others.
  • 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.
  • on00557
    Meat Inspection Program Animal Health Discussion Request Form

    This Meat Inspection Program Discussion Request Form is intended for use when further discussion is requested by producers/consigners and/or herd/flock veterinarians regarding condemnations or dispositions made at provincially licensed meat plants in Ontario and information included on Form 202: Whole and/or Partial Carcass(es) Condemnations.