BUSINESS INFORMATION

BUSINESS NAME
CURRENT BUSINESS LICENCE NO.

Sole Proprietorship _ Partnership - Corporation

BUSINESS LOCATION

Units Occupied (List the individual units your Business Occupies)

House No. Street

Postal Code

7 ‘Business Phone Fax No. — | Cellular

; | MAILING ADDRESS IF DIFFERENT FROM ABOVE (List unit # for mail if more than one is
ce occupied): _ oe — |

. 1 Address.

City = Province _ ~. Postal Cade

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- OWNER'S N " OWNERSHIP INFORMATION |
/ OWNER'SNAME .

-. OWNER’S ADDRESS

‘

“HOUSENO. STREET

PROVINCE. —~—~*~C“C*‘“‘:*‘éOSAL CODE

RENEWAL

Renewed for the calendar year

: