11-102F1 - Notice of Principal Regulator and Registration in Additional Jurisdiction(s) [F Proposed - Lapsed]
| Published Date: | 2007-03-28 |
|---|---|
| Rescinded Date: | 2012-05-30 |
| Document(s): |
|
Concurrently Published:
(for firms)
1. Date: _____________________
2. Information about the firm
NRD #:
Name:
3. Information relevant to principal regulator determination - head office
Is your head office located in Canada? Yes cNo c
If yes, identify the jurisdiction and proceed to item 5:
______________________
4. Information relevant to principal regulator determination - significant connection
If your head office is not in Canada, identify the jurisdiction where you expect to have the highest volume of business by assets under management
______________________
5. Registration in Additional Jurisdiction(s)
Indicate the jurisdiction(s), other than the jurisdiction you identified under item 3 or 4, in which you are to be registered under section 4.2 of NI 11-102 by checking the relevant box(es):
British Columbia | c |
Alberta | c |
Saskatchewan | c |
Manitoba | c |
Ontario | c |
Québec | c |
New Brunswick | c |
Nova Scotia | c |
Prince Edward Island | c |
Newfoundlandand Labrador | c |
Yukon | c |
Northwest Territories | c |
Nunavut | c |
6. Address and agent for service
For each jurisdiction identified in item 5, provide the following information:
If you have not appointed an agent for service, an address for service (a post office box is not an acceptable address, but a residential address is):
_______________________
Number, street
_______________________
City, province or territory, postal code
_______________________
Telephone number
_______________________
Fax number, if available
_______________________
E-mail address, if available
If you have appointed an agent for service, the following information for the agent for service. (The address for your agent for service must be the same as the address for service above. If your agent for service is a firm, also provide the name of your contact person):
_______________________
Name
_______________________
Contact person
_______________________