Client NO.:
Firm Name:
Address:
Contact:
Telephone NO.:
Fax NO.:
E-mail Address:

1.	General Information
	(a)  Business Corporation	Not for Profit Corporation
	(b)  Initial Return	Notice of Change
2.	Ontario Corporation Number
3.	Date of Incorporation or Amalgamation	(FORMAT: YYYY/MM/DD)
4.	Corporation Name (including punctuation)
5.	Address of Registered or Head Office
	Care of /Attention:
	Suite	Street Number
	Street Name
	City	Province
		Alberta British Columbia Manitoba New Brunswick Newfoundland Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
	Country	Postal Code
6.	Mailing Address
	Same as Registered or Head Office	Not Applicable
	Care of /Attention:
	Suite	Street Number
	Street Name
	City	Province
		Alberta British Columbia Manitoba New Brunswick Newfoundland Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
	Country	Postal Code
7.	Language of Preference
	English	French
8.	Filing Authorization
	I,            (Type name in full of the person authorizing the filing) Certify that the information set out herein, is true and correct.
	Check appropriate box:	Director
		Officer
		Other individual having knowledge of the affairs of the Corporation

	Director/Officer Information 1
	Last Name	First Name	Middle Name
	Suite No.	Street No.
	Street Name
	City	Province	"Other" for U.S.A or European
		Alberta British Columbia Manitoba New Brunswick Newfoundland Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Other
	Country	Postal Code
	Director Information
	Resident Canadian (applies to directors only)		Yes      No
	Date Elected        Date Ceased
	(FORMAT: YYYY/MM/DD)                                (FORMAT: YYYY/MM/DD)
	Officer Information
		Date Elected	Date Ceased
	President
	Secretary
	Treasurer
	General Manager
	Other	(FORMAT: YYYY/MM/DD)	(FORMAT: YYYY/MM/DD)
	Chair Chairperson Chairman Chairwoman Vice-Chair Vice-President Assistant Secretary Assistant Treasurer Chief Manager Executive Director Managing Director Chief Executive Officer Chief Financial Officer Chief Information Officer Chief Operating Officer Chief Administrative Officer Comptroller Authorized Signing Officer Other