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.

Did you know?

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.

Note

This form can be signed electronically.

End of note

Note

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

End of note

Note

Our downloadable documents may not comply with Web accessibility standards. If you are having problems using them, please contact us.

End of note