Page 1

Government of Ontario: Ministry of Finance

33 King Street West
PO Box 625
Oshawa ON  L1H 8E9

1-866-ONT-TAXS
1-866-668-8297

Application for Refund - Summary
Loss of Product (PRL) 2015/2016

Effective for Purchases from March 2, 2015 to February 29, 2016

Alcohol, Cannabis and Gaming Regulation and Public Protection Act, 1996

Guide available at ontario.ca/finance on webpage 3062: Guide for Completing the Application for Refund – Loss of Product (PRL) Summary and Schedule

Fields marked (*) are mandatory fields.

Product type *

Legal name * and address




A. Ownership information

Type of legal entity (check one)

        

Name of Owners/Director





Address







Signing officer

  

Summary From
To
Refund claim amount ($)
Total from attached schedule
B. Invoice dates

Certification

Please ensure that an authorized person signs the application. It is an offence to make a false statement in an application.
I certify that the information in this application is, to the best of my knowledge and belief, true, correct and complete.
I certify that tax and amounts on account of the tax under the Alcohol, Cannabis and Gaming Regulation and Public Protection Act, 1996, in respect of the product for which this refund is claimed have been remitted to the Minister or have been paid over to the person(s) from whom the product was purchased for remittance to the Minister. I certify that compensation for the loss is not available, has not been received, nor is compensation for the loss being sought, other than through this application.





   

Warning Penalties may be imposed if an applicant for a refund has misrepresented a material fact on or in connection with an application for refund or in an invoice supporting the application.
Charges may be laid and fines result, where a person obtains or attempts to obtain a refund by deceit, falsehood or any fraudulent means.

This application and any refund payment are subject to audit by the Ministry of Finance.

Ministry Use

   

Page 2

Government of Ontario: Ministry of Finance

Application for Refund - Schedule
Loss of Product (PRL) 2015/2016

Effective for Purchases from March 2, 2015 to February 29, 2016

Alcohol, Cannabis and Gaming Regulation and Public Protection Act, 1996

Beer Schedule – Loss of Product


Guide available at ontario.ca/finance on webpage 3062


A. Loss of product

Date of loss:

Type of loss (check one)

Complete a separate summary and schedule for each type of loss.
  

B. Refund calculation

Basic tax
Beer type A. Total litres purchased
per beer type
B. Total refundable litres
per beer type
C. Ontario beer
basic tax rate
D. Refund claim amount
per beer type ($)
D = (B × C)
Beer Manufacturer Draft 0.6315
Beer Manufacturer Non-Draft 0.7963
Microbrewer Draft 0.2666
Microbrewer Non-Draft 0.2964
Total Refund claim amount ($) Box 1 + 2 + 3 + 4
Volume tax
Total refundable litres
Ontario beer volume tax rate 7. 0.1760
Refund claim amount ($)
Box 6 × 7
Environmental tax
Total number of non-refillable containers
Ontario environmental tax rate 10. 0.0893
Refund claim amount ($)
Box 9 × 10
Total refund claim amount ($)
Box 5 + 8 + 11

Include this amount in Box C in the Summary, page 1.

return to summary page