TRISTAR AUTO PARTS
1110 BIRCHMOUNT ROAD
UNIT #15
SCARBOROUGH, ONT.
MIK 5G7
ONTARIO RETAIL SALES TAX
PURCHASE EXEMPTION CERTIFICATE
BUSINESS NAME: ---------------------------------------------------------------------------------------------
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BUSINESS ADDRESS: ---------------------------------------------------------------------------------------------
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VENDER PERMIT NUMBER:-------------------------------------------------------------------------------------------
NATURE OF BUSINESS: ---------------------------------------------------------------------------------------------
Under the provision of the Retail Sales Tax Act the above-named business claims exemption from tax on
the following items of tangible personal property and on the following taxable services.
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Signature of Authorized Person Date
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Name of Authorized Person