Cvor Application Form – Fill Out and Use This PDF

Commercial Vehicle Operator’s Registration (CVOR) Application -

Corporation or Partnership

This application is to be completed only by carriers that operate commercial motor vehicles plated in

Ontario, the United States of America (USA) or Mexico that travel in Ontario.

Instructions

Ministry Use Only

Op No.

Office No.

• Complete and sign this application and return with the required fee. Incomplete applications will be

returned unprocessed to the sender.

Assigned to:

• If you are doing business as an Individual or Sole Proprietorship complete the CVOR Application

for Individual (SR-LC-018).

Application No:

• You must include the required supporting documentation that identifies your company name

(certificate/articles of incorporation, letters patent, certificate/articles of amendment or amalgamation).

Certificate No:

• Limited partnerships - see Part 4, Business Information.

Processed on:

• Allow a minimum of 15 business days for application processing.

Y

M

D

• Mail completed application to: Ministry of Transportation, Carrier Sanctions and Investigation Office,

Amount Received

CVOR Processing Section, 301 St. Paul Street, 3rd Floor, St. Catharines ON L2R 7R4 or fax to

$

905 704-2525 or 905 704-3033.

Method of Payment

For additional information please visit www.mto.gov.on.ca or contact Carrier Sanctions and Investigation Office

Cash

Credit Card

at 1 800 387-7736 or 416 246-7166.

Cheque

Money

Part 1 - Purpose of this Application

Certified

Order

Check  the purpose of your application.

Cheque

To obtain an Original CVOR Certificate. $250.00 fee applies.

To replace a lost, stolen or damaged CVOR Certificate. $5.00 fee applies.

Note: To update an existing CVOR record please call the number above to order an application.

Part 2 - Method of Payment

Check  your method of payment below.

•If paying by credit card via fax or mail, attach the Credit Card Authorization Form (SR-LV-034).

•If paying by cheque or money order, make payable to the "Minister of Finance/MTO". Post-dated cheques are not accepted.

•Payment in Canadian funds only. Do not send cash in the mail.

Part 3 - Registrant Information

CVOR Number/Registrant Identification Number (R.I.N) (if it has been assigned)

–

–

Name of Operator (provide full legal name of corporation or partners)

Head Office Address - Street No. and Name, Lot, Con. and Twp. (A post office box will not be accepted)

Apt/Unit No.

City/Town/Village

Province/State

Country

Postal/Zip Code

Mailing Address (if different from above) - Street No. and Name, Lot, Con. and Twp.

Apt/Unit No.

City/Town/Village

Province/State

Country

Postal/Zip Code

Preferred Language

English

French

SR-LC-017 2012-06

© Queen’s Printer for Ontario, 2012

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Part 3 - Registrant Information continued

Part 4 - Business Information

If you are doing business under more than one (1) business name, or are a limited partnership, contact the ministry to obtain information about setting up fleeted registrant identification numbers (RINs) by faxing your request to 416 235-4414 or mail your request to Ministry of Transportation, Licencing Administration and Support Office, Special Enquiry Unit, 2680 Keele Street, Building A, Room 178, Downsview ON M3M 3E6.

Registered Trade Name or Name of Partnership (submit a copy of master business licence or business registration document)

Ontario Commercial Motor Vehicle Licence Plate Number

Yes No

1. Do you operate any Ontario Motor Vehicle Inspection Stations (MVIS)? If Yes checked  complete (a) and (b) below........

2. Do you operate commercial motor vehicles outside Ontario? If Yes checked  complete (a) and (b) below.....................

(a) Enter the United States Department of Transportation (US DOT) Number (if applicable)

Part 5 - Type of Operator (Carrier)

Check  your operator type.

H For-Hire Carrier - transports goods and/or passengers for direct or indirect compensation

P Private Carrier - goods are the property of the carrier; goods and/or passengers are transported without compensation

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Part 6 - Type of Commercial Vehicle (Trucks and/or Buses)

Check  the type of commercial motor vehicle you operate in Ontario:

Truck(s) Only - If checked  indicate up to three (3) main commodities you transport by order of priority, from Category 1 below (e.g. Write the number 1 beside the main commodity you transport, write the number 2 beside the second commodity you transport, etc).

Bus(es) Only - If checked  indicate up to three (3) types of passenger service you provide by order of priority, from Category 2 below (e.g. Write the number 1 beside your main type of bus service).

Truck(s) and Bus(es) - If checked  indicate at least one (1) commodity you transport from Category 1 and at least one (1) passenger service you provide from Category 2. The total number of commodities/passenger services selected should not exceed three (3).

Note: If you operate a truck(s) and do not carry any commodities (e.g. you operate a utility or an empty vehicle), place a check  beside "NO None (other activities)" in Category 1.

Part 7 - Dangerous Goods/HAZMAT Carrier

Yes No

Do you transport dangerous goods in a quantity that requires placards to be displayed on the vehicle?

If Yes checked  complete Part A below......................................................................................................................

Part A - Check  the classification for the types of dangerous goods that you transport.

1 Explosives

2.1 A Flammable Gas

2.2 A Non-Flammable, Non-Toxic Gas

2.3 A Poisonous Gas

3 Flammable Liquids

4 Flammable Solids; Substances Liable to Spontaneous Combustion; Substances that on contact with water emit flammable gases (water-reactive substances)

5 Oxidizing Substances and Organic Peroxides

6 Poisonous Substances and Infectious Substances

7 Radioactive Materials

8 Corrosive Substances

9 Miscellaneous Products, Substances or Organisms

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Part 8 - Operational Data

•The information you provide in this section must include all of the trucks and/or buses plated in Ontario, USA or Mexico that travel in Ontario under your CVOR number. Include trucks and/or buses that you own, lease or rent and any that are operated by owner-operators on your behalf.

•Only include information about trucks with a gross vehicle weight (GVW) and/or registered gross weight (RGW) over 4,500 kgs (9,921 lbs). Do not include any trailer information.

•Only include information about buses that carry ten (10) or more passengers, do not include the driver.

•Actual kilometres reported can be used in any future Ministry Facility Audit.

Note - CMV's excluded from the CVOR program are: Ambulances, Buses that are used for personal purposes without compensation, Casket Wagons, CMV's leased for no longer than 30 days for personal use or the carriage of passengers, without compensation, Empty CMV's operating under dealer/service plates or special permit, Fire Apparatuses, Hearses, Motor Homes, Vehicles commonly known as tow trucks, mobile cranes unless not excluded in an oversize/overweight permit issued by MTO. For current exemptions relating to personal use pickup trucks see the HTA and O.Reg 425/97.

Indicate when you started/will start operating your Trucks and/or Buses (Start date(s) will be used in the chart below)

Trucks Start Date:

For the time periods specified, enter the total

Actual j

Estimated

number of:

From applicable Start Date(see above)

For the next 12 months of operations

• trucks and/or buses operating

to Current Date ( if applicable)

based on Current fleet size

•

kilometres traveled

From:

Y

M

D

From:

Y

M

D

•

drivers

Indicate both the Actual and Estimated value.

To:

Y

M

D

To:

Y

M

D

Truck Information Only

Total Number of Trucks k

Total Number of Trucks Double Shifted l

Total kilometres traveled in Ontario

km

km

Total kilometres traveled in the rest of Canada

km

km

(Do not include Ontario)

Total kilometres traveled in the USA and Mexico

km

km

Total Number of Drivers m

Bus Information Only

Total Number of Buses k

Total Number of Buses Double Shifted l

Total kilometres traveled in Ontario

km

km

Total kilometres traveled in the rest of Canada

km

km

(Do not include Ontario)

Total kilometres traveled in the USA and Mexico

km

km

Total Number of Drivers

j1 mile = 1.609 kms.

kIf fleet size varied during the time periods noted, average the number of vehicles.

l"Double Shifted" means the number of trucks/buses that are operated by two (2) or more individual drivers who work separate shifts of at least eight (8) hours each in a 24 hour period more than 4 days per week.

mInclude drivers that may own their trucks and are under contract with you (the operator) to work under your CVOR certificate (trucks plated in Ontario, the USA or Mexico only).

© Queen’s Printer for Ontario, 2012

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Part 9 - Corporate Data

•Officers, Directors or Partners - You must include President, CEO or CFO information.

•For corporate officer changes you must include your resolution of directors document, Ontario Corporation Form 1 or meeting minutes outlining changes.

•Report additional officers, directors or partners on a separate sheet of paper.

Driver's Licence No.

Province, State or Country Issued

Gender

Date of Birth

Male

Female

Y

M

D

Last Name, First Name and Initials

Street No. and Name, Lot, Con. and Twp. (A post office box will not be accepted)

Apt./Unit No.

City/Town/Village

Province/State

Country

Postal/Zip Code

Position within the Company

Driver's Licence No.

Province, State or Country Issued

Gender

Date of Birth

Male

Female

Y

M

D

Last Name, First Name and Initials

Street No. and Name, Lot, Con. and Twp. (A post office box will not be accepted)

Apt./Unit No.

City/Town/Village

Province/State

Country

Postal/Zip Code

Position within the Company

Driver's Licence No.

Province, State or Country Issued

Gender

Date of Birth

Male

Female

Y

M

D

Last Name, First Name and Initials

Street No. and Name, Lot, Con. and Twp. (A post office box will not be accepted)

Apt./Unit No.

City/Town/Village

Province/State

Country

Postal/Zip Code

Position within the Company

© Queen’s Printer for Ontario, 2012

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Part 10 - Insurance Information

Before a Commercial Vehicle Operator Registration certificate will be issued, the applicant must provide information of valid insurance coverage which meets minimum requirements as described in the Motor Vehicle Transport Act, Motor Carrier Safety Fitness Certificate Regulations, Section 7; the Public Vehicles Act of Ontario, Regulation 982, Section 14 and/or the Insurance Act of Ontario, Part VI; Automobile Insurance as applicable to the carrier’s specific operations.

Part 11 - Registrant Declaration

Failure to disclose this information may result in the suspension or cancellation of your operating privilege.

Yes No

To be Completed by New Registrants Only - Is your privilege of operating commercial motor vehicles currently suspended,

cancelled or revoked in any North American jurisdiction? If Yes checked  answer question (a) below......................................

(a) Which jurisdiction suspended, cancelled or revoked your privilege of operating a commercial motor vehicle?

I, the undersigned, declare that the information contained in this form is true and the insurance information provided above meets the minimum requirements set out by law. I acknowledge and accept the responsibilities imposed by law in relation to the operation of commercial motor vehicles.

Note: (1) This application must be signed by one of the officers, directors or partners identified in Part 9.

(2)It is an offence under subsection 9 (1) of the Highway Traffic Act to make a false declaration or to provide false information. This may result in penalties as provided under the Act and/or suspension or refusal of your CVOR certificate.

Part 12 - Contact Person for this Application

Last Name, First Name and Middle Initial(s)

Position/Relationship to the Operator

Part 13 - Corrections or Changes in the Operator's Name and/or Address

•To report a name and/or address change/correction, take the appropriate legal documents and your current Ontario driver's licence to any ServiceOntario Office. Locations are provided on the MTO Website or by phone at 416 235-2999 or 1 800 387-3445.

•Address changes may also be made online at ServiceOntario.ca or at a ServiceOntario kiosk.

•Name changes only - A CVOR certificate will be reissued, free of charge.

The information requested in this application is collected under the authority of the Ontario Highway Traffic Act and the federal Motor Vehicle Transport Act. The information is used to evaluate eligibility to obtain and hold a CVOR certificate and also to create and maintain a public record. Direct enquires to Ministry of Transportation, Carrier Sanctions and Investigation Office (CSIO), Client Services, 301 St. Paul Street, 3rd Floor, St. Catharines ON L2R 7R4.

© Queen’s Printer for Ontario, 2012

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Credit Card Authorization Form

Applicant's Information

Office Use Only

Name / Company / Dealer

Operator No. Office No.

Street No. and Name, P.O. Box, R.R. or Lot, Con. and Twp.

Apt. / Suite No.

Business Date

Y

M

D

City, Town or Village

Fee Paid

Postal or Zip Code

Prov. or State

Country

Provide one (1) of the following Ontario identification numbers below.

If you do not have any of the information requested below check  the "Not Available / None of the above" box.

	Driver's Licence (DL) Number:
	Licence Plate Number:
	Registrant Identification Number (RIN):		Dealer Number:
	Commercial Vehicle Operator's Registration		National Safety Code
	(CVOR) Number:		(NSC) Number:
	Motor Vehicle Inspection Station (MVIS) Number:
	Vehicle Identification Number (VIN):
	Not Available / None of the above
Under provincial legislation, a false statement from the applicant may result in a penalty.

The personal information provided by you on this form is collected to assist with payment verification for the Ministry of Transportation’s driver, vehicle and carrier products and services, for which the Ministry is responsible under the Highway Traffic Act. If you have any questions about the information collected on this form, please contact the Operations Manager, ServiceOntario Driver & Vehicle Contact Centre at 416 235-2999 or 1 800 387-3445 or visit ServiceOntario.ca.

SR-LV-034 2012/05 (p)

© Queen’s Printer for Ontario, 2012 Medium Sensitivity when completed