Payment of fees - Commission des transports du Québec

Payment of fees
The information provided on this form is confidential and will be used exclusively to
process the fees applicable to your application.
CTQ use only
IMPORTANT
Numéro de demande :

The possible methods of payment are: direct payment or cash (at the counter
only, credit card, personal cheque or money order (payable to the Minister of
Finance).
Numéro de revenu :
Complete this form only for credit card payment.
Date :

Vérifié par :
1 – Details of payment
Visa
Master Card
American Express
Expiration date
Credit card number
Month Year
RIN or file number (if available)
Amount paid
2 – Signature
Signature
Name (in block letters)
Year
Month Day
Submit your application
Send the signed form along with the payment and the required documents:
By secure email
www.ctq.gouv.qc.ca/en/to_reach_us
By fax
514 873-4720 or 418 644-8034
Commission des transports du Québec
e
200, chemin Sainte-Foy, 7 étage
Québec (Québec)
G1R 5V5
By mail
In person
545, boulevard Crémazie Est
e
10 étage, Bureau 1000, Montréal
e
200, chemin Sainte-Foy, 7 étage
Québec
To reach us
Internet address
www.ctq.gouv.qc.ca
By phone
Montreal area: 514 873-6424
All other areas: 1 888 461-2433
Commission des transports du Québec
CTQ-317A (2016-05)