Application for Compensation for Losses Due to Evaporation
CA-53-V

This form is intended for wholesale or retail dealers who hold a registration certificate but who have not concluded an agreement with the Minister of Revenue and who wish to apply for compensation for gasoline lost due to evaporation.

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After completing the form onscreen and saving it on your workstation, you can send it to us using our Submit a consumption tax rebate application online service. Access the service in My Account for businesses or My Account for professional representatives, or use clicSÉQUR express. It's fast, easy and environmentally friendly.

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Note about electronic signatures.

This form can be signed electronically.

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To complete the form, save it to your computer and open it in Adobe Reader.

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2020-05 version

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