Page # of Total Pages
Reg YR
CARRIER'S NAME ACCOUNT NUMBER ON SUPP # FLEET RIN FLEET # EFFECTIVE DATE CONTACT PERSON PH # Fax #
Vehicle Transaction Code AV - Add Vehicle AR - Add Vehicle Using Credit RP - Replace Plate DV - Delete Vehicle DR - Delete Vehicle Using Credit RC - Replace Cab Card
1. Line No. 1. Transaction Code 1. Owner's Unit # 1. Weight Group # 1. Current Plate # 1. Vehicle Identification Number ( VIN ) 1. Vehicle Colour 1. Vehicle Year 1. Vehicle Make 1.Fuel Type 1.Veh. Type 1. RIN 1. Owner/Operator or Leasing Company
2. Line No. 2. Transaction Code 2. Owner's Unit # 2. Weight Group # 2. Current Plate # 2. Vehicle Identification Number ( VIN ) 2. Vehicle Colour 2. Vehicle Year 2. Vehicle Make 2.Fuel Type 2.Veh. Type 2. RIN 2. Owner/Operator or Leasing Company
3. Line No. 3. Transaction Code 3. Owner's Unit # 3. Weight Group # 3. Current Plate # 3. Vehicle Identification Number ( VIN ) 3. Vehicle Colour 3. Vehicle Year 3. Vehicle Make 3.Fuel Type 3.Veh. Type 3. RIN 3. Owner/Operator or Leasing Company
4. Line No. 4. Transaction Code 4. Owner's Unit # 4. Weight Group # 4. Current Plate # 4. Vehicle Identification Number ( VIN ) 4. Vehicle Colour 4. Vehicle Year 4. Vehicle Make 4.Fuel Type 4.Veh. Type 4. RIN 4. Owner/Operator or Leasing Company
5. Line No. 5. Transaction Code 5. Owner's Unit # 5. Weight Group # 5. Current Plate # 5. Vehicle Identification Number ( VIN ) 5. Vehicle Colour 5. Vehicle Year 5. Vehicle Make 5.Fuel Type 5.Veh. Type 5. RIN 5. Owner/Operator or Leasing Company
1. Line No. 1. Truck Axles Include Steering Axle 1. Trailer Axles 1. Tare Wgt 1. Purchase Amount/Lease Capital Cost CDN $ 1. Purchase Amount/Lease Capital Cost US $ 1. Date of Purchase/Lease 1. Factory Price Actual (US $) 1. Trade-In Value ($)
1. (For Office Use Only) New Plate #
2. Line No. 2. Truck Axles Include Steering Axle 2. Trailer Axles 2. Tare Wgt 2. Purchase Amount/Lease Capital Cost CDN $ 2. Purchase Amount/Lease Capital Cost US $ 2. Date of Purchase/Lease 2. Factory Price Actual (US $) 2. Trade-In Value ($)
2. (For Office Use Only) New Plate # 3. Line No. 3. Truck Axles Include Steering Axle 3. Trailer Axles 3. Tare Wgt 3. Purchase Amount/Lease Capital Cost CDN $ 3. Purchase Amount/Lease Capital Cost US $ 3. Date of Purchase/Lease 3. Factory Price Actual (US $) 3. Trade-In Value ($)
3. (For Office Use Only) New Plate #
4. Line No. 4. Truck Axles Include Steering Axle 4. Trailer Axles 4. Tare Wgt 4. Purchase Amount/Lease Capital Cost CDN $ 4. Purchase Amount/Lease Capital Cost US $ 4. Date of Purchase/Lease 4. Factory Price Actual (US $) 4. Trade-In Value ($)
4. (For Office Use Only) New Plate #
5. Line No. 5. Truck Axles Include Steering Axle 5. Trailer Axles 5. Tare Wgt 5. Purchase Amount/Lease Capital Cost CDN $ 5. Purchase Amount/Lease Capital Cost US $ 5. Date of Purchase/Lease 5. Factory Price Actual (US $) 5. Trade-In Value ($)
5. (For Office Use Only) New Plate #
1. Line No. 1. Annual Km Over 16,093?
1. Vehicle Identification Number (VIN) 1. Fleet RIN 1. Fleet # 1. Plate # 1. Unit # 1. Year 1. Make
1. Company Name 1. Policy # 1. Expiry Date
2. Line No. 2. Annual Km Over 16,093?
2. Vehicle Identification Number (VIN) 2. Fleet RIN 2. Fleet # 2. Plate # 2. Unit # 2. Year 2. Make
2. Company Name 2. Policy # 2. Expiry Date
3. Line No. 3. Annual Km Over 16,093?
3. Vehicle Identification Number (VIN) 3. Fleet RIN 3. Fleet # 3. Plate # 3. Unit # 3. Year 3. Make
3. Company Name 3. Policy # 3. Expiry Date
4. Line No. 4. Annual Km Over 16,093?
4. Vehicle Identification Number (VIN) 4. Fleet RIN 4. Fleet # 4. Plate # 4. Unit # 4. Year 4. Make
4. Company Name 4. Policy # 4. Expiry Date
5. Line No. 5. Annual Km Over 16,093?
5. Vehicle Identification Number (VIN) 5. Fleet RIN 5. Fleet # 5. Plate # 5. Unit # 5. Year 5. Make
5. Company Name 5. Policy # 5. Expiry Date
SALES TAX - ONTARIO
1. Line No. 1. True Lease 1. Third Party Lease 1. RIN: Owner/Operator (if leased vehicle) 1. Owner/Operator's Name 1. IFTA Account # (if different from fleet)
2. Line No. 2. True Lease 2. Third Party Lease 2. RIN: Owner/Operator (if leased vehicle) 2. Owner/Operator's Name 2. IFTA Account # (if different from fleet)
3. Line No. 3. True Lease 3. Third Party Lease 3. RIN: Owner/Operator (if leased vehicle) 3. Owner/Operator's Name 3. IFTA Account # (if different from fleet)
4. Line No. 4. True Lease 4. Third Party Lease 4. RIN: Owner/Operator (if leased vehicle) 4. Owner/Operator's Name 4. IFTA Account # (if different from fleet)
5. Line No. 5. True Lease 5. Third Party Lease 5. RIN: Owner/Operator (if leased vehicle) 5. Owner/Operator's Name 5. IFTA Account # (if different from fleet)
FOR OFFICE USE ONLY Record Stock:
Authorized Signature Date City/Town Prov/State
Link to Form 1
Link to Form 2
Link to Form 3
Link to Form 4 (Bus)