Primary Weight Permit Application (TEST FORM)

Type(Required)

Agriculture

Oilfield

Other

Request For(Required)

Daily Test - $0.50 + GST

Yearly Test - $0.60 + GST

Date(Required)

Company(Required)

Mailing Address(Required)

Box Number/Street Address City Province Postal Code

Phone(Required)

Email(Required)

Unit No.

License Plate No.(Required)

Gross Vehicle Weight(Required)

No. of Axles(Required)

Steering Axle Weight

Total Axle Weight

GST (5%)

Price: $ 0.00 CAD

Total

Invoice To:(Required)

First Name Last Name

Credit Card(Required)

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