Company Information

Company Details
Registered Business Name  
Business Operating Name  
Business Address  
Mailing Address  
Telephone(s)  
Fax  
Cellular Phone  
Email  
Website  
Date Established  
Current Ownership Since  
Form of Business:

_______ Corporation

_______ Non-Profit Society

_______ Partnership

_______ Cooperative

_______ Sole Proprietorship

_______ Other: ___________________________

Industry Sector:  
Current Financial Institutions:  
Company Owner(s) — Supply Same Information for Each Owner
Legal Name  
Business Name  
% Ownership  
Title:  
Business Involvement:

_________ Part-time

_________ Full-time

Accountant
Name  
Address  
Telephone  
Fax  
Email  
Fiscal Year End  
Date of most recent formal accountant prepared financial statements or corporate income tax return  
Latest interim statements (if applicable)  
Lawyer
Name  
Address  
Telephone  
Fax  
Email  

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