DARREN GLADYSZ A V O C A T I N C. T R A D E M A R K A G E N T
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1 DARREN GLADYSZ A V O C A T I N C. T R A D E M A R K A G E N T 1980 PÉRODEAU VAUDREUIL-DORION, QUÉBEC, J7V 8P7 TÉLÉPHONE: (450) FAX: (450) dgladysz@videotron.ca INCORPORATION QUESTIONNAIRE Date of request SECTION 1 CLIENT INFORMATION Please complete our Incorporation Questionnaire and fax it to us at (Please complete your coordinates or those of the contact person) First Name Family Name Correspondence Address Telephone (include area code) Fax (include area code) By what means do you prefer we communicate with you? Fax Telephone By what means did you hear of our firm? Yellow Pages Reference by an existing client Internet Other : SECTION 2 TYPE OF COMPANY Federal Incorporation (Canada) Canada Business Corporations Act Numbered Company (ie Canada Inc.) Provincial Incorporation (Quebec) Part 1A of the Quebec Compagnies Act Numbered Company (ie Québec Inc.) Numbered Company with tradename ie. ABC Computer a division of Canada Inc. With a compagny name ie. ABC COMPUTERS INC. Numbered Company with tradename ie. ABC Computer a division of Quebec Inc. With a compagny name ie. ABC COMPUTERS INC. Language for incorporation documents French English Form_incorp_eng_05_06 page 1 de 5
2 SECTION 3 SHARE-CAPITAL Standard Custom (Please contact us for applicable fees and additional cost) SECTION 4 PROPOSED NAMES French Name (IMPORTANT : Any company doing business in the province of Quebec must have a French name) 1 st choice 2 nd choice 3 rd choice English Name (IMPORTANT : the English name must be an exact translation of the French name) 1 st choice 2 nd choice 3 rd choice SECTION 5 ADDRESS OF HEAD OFFICE Street Number and Street Name Country City, Province, Postal Code Judicial District (if unknown leave blank) Is the correspondence address the same as the Head Office? Yes (Please complete the following SECTION 6 CORRESPONDENCE ADDRESS Street Number and Street Name Country City, Province, Postal Code Judicial District (if unknown leave blank) SECTION 7 NATURE OF ACTIVITIES 1 st sector of activity Percentage 2 nd sector of activity Percentage Form_incorp_eng_05_06 page 2 de 5
3 SECTION 8 NUMBER OF EMPLOYEES Quebec Canada SECTION 9 BANK OR FINANCIAL INSTITUTION Name Address SECTION 10 ACCOUNTANT Name Auditor Chartered accountant (CA) CGA Accountant Address SECTION 11 FINANCIAL YEAR END What is the date of the company s financial year end? SECTION 12 DIRECTORS, SHAREHOLDERS AND OFFICERS 1 ST DIRECTOR, SHAREHOLDER AND/OR OFFICER Country of de residence Yes Is this person also an officer? NOTE : for a sole shareholder/director we recommend President-Secretary NOTE : We recommend issuing 100 Class A Common shares at $1.00 each and allocating these to the shares according to their percentage in the Company. We cannot issue fraction of shares, so for 3 shareholders having equal shares, we recommend 33 shares each. Class of Shares Form_incorp_eng_05_06 page 3 de 5
4 ND 2 DIRECTOR, SHAREHOLDER AND/OR OFFICER (IF APPLICABLE) Yes RD 3 DIRECTOR, SHAREHOLDER AND/OR OFFICER (IF APPLICABLE) Yes Form_incorp_eng_05_06 page 4 de 5
5 ADDITIONAL DIRECTOR, SHAREHOLDER AND/OR OFFICER (IF APPLICABLE) Yes profession ADDITIONAL DIRECTOR, SHAREHOLDER AND/OR OFFICER (IF APPLICABLE) Yes profession Form_incorp_eng_05_06 page 5 de 5
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