Form 1159E "Motor Vehicle Appraisal Record" - Ontario, Canada

Form 1159E or the "Motor Vehicle Appraisal Record" is a form issued by the Ontario Ministry of finance.

The form was last revised in February 1, 2012 and is available for digital filing. Download an up-to-date fillable Form 1159E in PDF-format down below or look it up on the Ontario Ministry of finance Forms website.

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Download Form 1159E "Motor Vehicle Appraisal Record" - Ontario, Canada

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Ministry of Finance
Motor Vehicle Appraisal Record
Retail Sales Tax
33 King Street West
PO Box 623
Oshawa ON L1H 8H7
Clear Form
1 - Dealer/Appraiser Information
Dealer No.
Independent Appraiser No.
Retail Motor Vehicle Dealer:
Yes
No
MF
Dealer or Independent Appraiser Name
Telephone No.
Address
City, Town, Village, R.R.
Province
Postal Code
Name of Current Purchaser
(Please Print)
Motor Vehicle Dealers Act Registration Number of Person Completing/Signing this Appraisal
Date of Inspection
Position of appraiser within the company
2 - Vehicle Description and Appraisal
Vehicle Identifi cation No.
Make
Year
Model
No. of Cylinders
Odometer Reading (kms) on Date of Inspection
Colour
Transmission Type:
Automatic
Manual
Options
Options
Options
Yes
No
Yes
No
Yes
No
General Condition of
Vehicle:
Air Conditioning
Cruise Control
Power Seats
Power Steering
Power Locks
Cassette AM/FM
Good
Power Brakes
Tilt Wheel
Radio AM/FM
Average
Power Windows
Two Door
Four Door
Poor
General Comments Affecting the Value of the Vehicle:
Appraised Value
$
NOTE: The appraised value of a vehicle is NOT intended to be trade-in value but represents the value that one might
expect to receive in a sales transaction between a willing buyer and a willing seller. Appraisals completed by persons
not recognized as appraisers by the Ministry of Finance, will not be accepted by the Ministry of Finance or the
Ministry of Transportation. Appraisals must be done within 60 days of the date of purchase.
Certifi cation
I hereby certify that I/we hold a current registration under the Motor Vehicle Dealers Act, my/our primary business is the
sale of new or used cars OR I hereby certify that I am an independent authorized appraiser authorized by the Ministry of
Finance to do appraisals of motor vehicles. I certify that the appraised value of the vehicle is lower than average due to
severe damage or excessive wear.
Signature
Print Name in Full
Date
year
month
day
Every person who knowingly makes a false or deceptive statement herein is guilty of an offence and is liable on conviction to a fi ne, or term of imprisonment,
or both (Retail Sales Tax Act, Subsections 32(4) and 32(4.1)).
Personal information is collected on this form under the authority of the Ontario Retail Sales Tax Act, R.S.O. 1990, c.R.31, (as amended) and may be used
to determine eligibility for a refund of retail sales tax. Questions about this collection should be directed to: Client Services Branch, 33 King Street West,
PO Box 623, Oshawa ON L1H 8H7, 1 866 668-8297.
Print Form
1159E(2012/02)
© Queen’s Printer for Ontario, 2012
Disponible en français
Ministry of Finance
Motor Vehicle Appraisal Record
Retail Sales Tax
33 King Street West
PO Box 623
Oshawa ON L1H 8H7
Clear Form
1 - Dealer/Appraiser Information
Dealer No.
Independent Appraiser No.
Retail Motor Vehicle Dealer:
Yes
No
MF
Dealer or Independent Appraiser Name
Telephone No.
Address
City, Town, Village, R.R.
Province
Postal Code
Name of Current Purchaser
(Please Print)
Motor Vehicle Dealers Act Registration Number of Person Completing/Signing this Appraisal
Date of Inspection
Position of appraiser within the company
2 - Vehicle Description and Appraisal
Vehicle Identifi cation No.
Make
Year
Model
No. of Cylinders
Odometer Reading (kms) on Date of Inspection
Colour
Transmission Type:
Automatic
Manual
Options
Options
Options
Yes
No
Yes
No
Yes
No
General Condition of
Vehicle:
Air Conditioning
Cruise Control
Power Seats
Power Steering
Power Locks
Cassette AM/FM
Good
Power Brakes
Tilt Wheel
Radio AM/FM
Average
Power Windows
Two Door
Four Door
Poor
General Comments Affecting the Value of the Vehicle:
Appraised Value
$
NOTE: The appraised value of a vehicle is NOT intended to be trade-in value but represents the value that one might
expect to receive in a sales transaction between a willing buyer and a willing seller. Appraisals completed by persons
not recognized as appraisers by the Ministry of Finance, will not be accepted by the Ministry of Finance or the
Ministry of Transportation. Appraisals must be done within 60 days of the date of purchase.
Certifi cation
I hereby certify that I/we hold a current registration under the Motor Vehicle Dealers Act, my/our primary business is the
sale of new or used cars OR I hereby certify that I am an independent authorized appraiser authorized by the Ministry of
Finance to do appraisals of motor vehicles. I certify that the appraised value of the vehicle is lower than average due to
severe damage or excessive wear.
Signature
Print Name in Full
Date
year
month
day
Every person who knowingly makes a false or deceptive statement herein is guilty of an offence and is liable on conviction to a fi ne, or term of imprisonment,
or both (Retail Sales Tax Act, Subsections 32(4) and 32(4.1)).
Personal information is collected on this form under the authority of the Ontario Retail Sales Tax Act, R.S.O. 1990, c.R.31, (as amended) and may be used
to determine eligibility for a refund of retail sales tax. Questions about this collection should be directed to: Client Services Branch, 33 King Street West,
PO Box 623, Oshawa ON L1H 8H7, 1 866 668-8297.
Print Form
1159E(2012/02)
© Queen’s Printer for Ontario, 2012
Disponible en français