Appendix 3 - British Columbia Used Oil Management Association Environmental Handling Charge Payment Schedule Remittance Form Registrant Name Remittance period start date Registration Number Remittance period end date Due date Volume sold (litres) Rate Remittance $0.05/litre $ under 8 inches (203mm) $0.55/filter $ 8 inches (203mm) and over $1.25/filter sump type automatic transmission $0.55/filter $ 500 ml $0.10/litre $ 0.947 litre (1 US quart) $0.10/litre $ 1 litre $0.10/litre $ 3.788 litre (1 US gallon) $0.10/litre $ 4 litre $0.10/litre $ 5 litre $0.10/litre $ 10 litre $0.10/litre $ 18.942 litre (5 US gallons) $0.10/litre $ 20 litre $0.10/litre $ under 500ml $0.10/litre $ Oil (litres)* Filters (by length): Containers (size)*: Subtotal $ GST @ 5% Other – please describe $ Total $ * Where oil is sold in kilograms the Environmental Handling Charge for oil and its container is to be remitted based on one kilogram equals one litre. I certify that the amounts indicated are the amounts of the Environmental Handling Charge that I am required to remit for the remittance period indicated. I certify and agree that I am holding all such amounts in trust for the Association and that the Association is entitled to audit and examine my records relating to the sale or distribution of oil lubricating products and remittance of the Environmental Handling charge. I further acknowledge that I have read, and agree to be bound by, the terms and conditions on the reverse (attached). Remittances must be received by the Association no more than 30 days after the end of a remittance period. Interest is charged at the rate of 1% per month on overdue remittances. Authorized signature Position Date Print name Phone Fax BCUOMA GST #892544701RT TERMS AND CONDITIONS In consideration of the registrant’s agreement to exercise his powers and carry out his duties in accordance with the Environmental Management Act (the "Act"), any regulations made under the Act (the "regulations"), and in consideration of the covenants contained herein, the registrant agrees as follows: 1. The registrant represents and warrants that all information provided to BCUOMA in this remittance, and in all documents required by virtue of registration with BCUOMA, or by virtue of the requirements of law, are true and accurate. 2. The registrant agrees to indemnify and hold BCUOMA, its employees and agents, harmless for all costs, expenses, claims, demands and actions that may arise as a result of any untrue or inaccurate statement or information provided by the registrant. 3. The registrant agrees to provide BCUOMA with all reasonable information relating to the requirements of the Regulation, agrees that BCUOMA has a right of access to any and all such information during normal business hours, or that BCUOMA shall be provided the required information on request. 4. The registrant hereby acknowledges and agrees that any payments made to BCUOMA as required are subject to verification of any information requested by BCUOMA, and subject to all required information being correct and sufficient for the purpose of BCUOMA. 5. Any payment made to BCUOMA by the registrant, where there is a false application or other false or inaccurate information provided by the registrant, shall be considered to have been granted or paid in mistake, or partial payment, in BCUOMA’s reasonable discretion. Any such payment (if less than the required amount) is deemed to be held in trust by the registrant for the sole and exclusive benefit of BCUOMA. Any such payment (if in excess of the required amount) shall be returned to the registrant or held by BCUOMA on the registrant’s behalf, at the discretion of BCUOMA. 6. BCUOMA reserves all rights and remedies provided to it under law that may be in addition to any terms contained herein. 7. The registrant acknowledges and agrees that BCUOMA has no obligation to advise of the lapsing of the registration, or advise of any circumstance which would alter the requirement of the registrant to be registered pursuant to the Regulation. The registrant is solely responsible for complying with the Regulation, all applicable laws, regulations, bylaws or enactments. Please remit to: British Columbia Used Oil Management Association PO Box 48359 Bentall Station Vancouver, BC V7X 1A5 If you wish to courier your remittance the courier address is as follows: British Columbia Used Oil Management Association Attention: Lockbox Department Suite 300, 815 West Hastings Street Vancouver, BC V6C 1B4 Remittance Instructions: Remittances must be received by the Association 30 days following the remittance period. Please make payment payable to the British Columbia Used Oil Management Association (BCUOMA). The Environmental Handling Charge is remittable on the sale or distribution of oil lubricating products in the province of British Columbia. In the event you have no applicable sales or distributions in a reporting period you are required to file a nil return. Administration fees and interest charges will be applied to all overdue amounts. Interest is payable at the rate of 1% per month on overdue remittances.
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