Motor Vehicle Safety Regulations

Ministerial Authorization

Pursuant to the Motor Vehicle Safety Act and the Motor Vehicle Safety Regulations,

[company name and address]

is authorized to use and apply the national safety mark, and the authorization number , to any vehicle of a class referred to in section 4 of the Motor Vehicle Safety Regulations, on condition that the vehicle and its components conform to all the applicable Canada Motor Vehicle Safety Standards.

The national safety mark and the authorization number are applied at the following premises: [identification of the premises]

This ministerial authorization expires on

Issued in Ottawa on , 20