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1 Submission Cover Page Fees Correspondence related to this submission will be sent to you using the contact information provided in the Submitter Information section of the form. Submission Fee: $ (go to for the current fee schedule) Select one (1) delivery method for your submission notification/certificate: Online workspace (please provide an address in the Submitter Information section) Fax: $5 additional fee $5 additional fee Mail: $10 additional fee Priority Service: $500 additional fee Priority submissions will receive immediate attention and will be reviewed within one business day after being received, where possible. If you are submitting multiple forms for a single entity, only one priority service fee is required. Check the Priority Service box on each submission cover page. Total Fees: $ Transactions will be rejected if sufficient funds are not available at the time of processing. Payment Methods ISC offers the following methods of payment: On account - Account number: Password: Cheque or money order payable to Information Services Corporation Credit card see instructions below Instructions to Register and Use an ISC Account Credit Card payments are made through an ISC account. To open an account, visit ISC.ca or contact the Customer Support Team To use your account: Sign in to ISC Online Services. Select Account Payment. Enter your credit card number, the name on the card and the expiry date. Under Payment $, enter the amount to be charged to your credit card. ** Please note: Only the main account holder can make payments online. If you are not the main account holder, please use one of the other payment methods. Customer Reference Number (optional) Your Reference Number:. Visit our website or contact our Customer Support Team for more information: corporateregistry@isc.ca Submission Methods: Mail: Corporate Registry Fax: (306) Online: st Avenue, Regina, SK S4R 8H2

2 The s Registration Act Section 1: Entity Details Has the business name been expired by the Corporate Registry in the last 90 days? Yes Entity Number: No (Required) Name Reservation Number: Name of Business Type select one (1): Sole Proprietorship Joint Venture Partnership Syndicate Name Conditions (if applicable): If conditions were applied in the name reservation, signed name conditions forms must be enclosed with this form. Section 2: Submitter Information Name: Mailing Address: Phone Number: Fax Number:

3 The s Registration Act Section 3: Addresses The physical address cannot be a post office box. Rural locations must use legal land descriptions, including R.M. names and numbers, or civic addresses. Business Physical Address Check here if mail cannot be delivered to this address Business Mailing Address Same as business physical address Address: City/Town : City/Town : Province : Other Physical Business Addresses If there are more than three (3), please photocopy this page before proceeding, and attach to this form. Location 2

4 The s Registration Act Location 3 Location 4 Section 4: Proprietor / Partner Details If the business name: Is a sole proprietorship, only one (1) proprietor is permitted. Is a partnership, joint venture or syndicate, there must be two (2) or more partners. If there are more than three (3) partners, please photocopy this page before proceeding, and attach to this form. A Power of Attorney form and Consent to Act form must be submitted to add a power of attorney if any of the following apply: The sole proprietor is an individual or trust and does not have a physical address in Saskatchewan. The partners are all individuals or trusts and none of the partners have a physical address in Saskatchewan. A power of attorney is not permitted if the proprietor or any of the partners has a Saskatchewan address. The physical address cannot be a post office box. Rural locations must use legal land descriptions, including R.M. names and numbers, or civic address.

5 The s Registration Act Proprietor / Partner 1 Proprietor / Partner Type select one (1): Individual Trust Body Corporate Entity Number: Limited Partnership Entity Number: Indian Band Entity Number: Name of Proprietor/Partner: Physical Address (for individual or trust only) Check here if mail cannot be delivered to this address Mailing Address (for individual or trust only) Same as physical address Address:

6 The s Registration Act Partner 2 Partner Type select one (1): Individual Trust Body Corporate Entity Number: Limited Partnership Entity Number: Indian Band Entity Number: Name of Partner 2: Physical Address (for individual or trust only) Check here if mail cannot be delivered to this address Mailing Address (for individual or trust only) Same as physical address Address:

7 The s Registration Act Partner 3 Partner Type select one (1): Individual Trust Body Corporate Entity Number: Limited Partnership Entity Number: Indian Band Entity Number: Name of Partner 3: Physical Address (for individual or trust only) Check here if mail cannot be delivered to this address Mailing Address (for individual or trust only) Same as physical address Address:

8 The s Registration Act Section 5: Registration Date The date of registration will be the date the properly completed forms and required fees are received in our office unless you specify a date in the future. If so, please indicate the date below. Registration Date: Section 6: Signature I certify that: If the entity is a partnership, any individuals who are listed as partners are 18 years of age or older. I am authorized to file these documents with the registrar. The information in this submission is true. Submitter Signature Date

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