Notice of Agent for Service

1. Name of Corporation

2. Corporate Access Number

3. Business Number (optional)

4. Agent for Service (Select the appropriate option)

Name of Agent for Service

Date of Resignation

Name of Agent for Service

Date of Revocation

5. The corporation has appointed

First Name

Middle Name (optional)

Last Name

Firm Name (optional)

as the corporation's

Date of Appointment

6. Full Address of Agent for Service

Street Address/Legal Land Description/Mailing Address

City or Town

Province

Postal Code

Email Address (mandatory)

7. Consent to act as Agent for Service

Name of Agent for Service (first, middle, last)

has consented to act as the agent for service of the above named corporation.

8. Authorized Representative/Authorized Signing Authority for the Corporation

First Name

Middle Name (optional)

Last Name

Relationship to Corporation

Email Address

Phone Number (optional)

Date of Submission

Signature

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[field id="Name of Corporation"]

[field id="Corporate Access Number"]

[field id="Business Number (optional)"]

[field id="Name of Agent for Service"]

[field id="as"]

[field id="Date of Resignation"]

[field id="Name of Agent for Service 2"]

[field id="as 2"]

[field id="Date of Revocation"]

[field id="First Name 1"]

[field id="Middle Name (optional) 1"]

[field id="Last Name 1"]

[field id="Firm Name (optional)"]

[field id="as the corporation's"]

[field id="Date of Appointment"]

[field id="Street Address"]

[field id="City or Town"]

[field id="Province"]

[field id="Postal Code"]

[field id="Email Address"]

[field id="Name of Agent for Service 3"]

[field id="First Name 2"]

[field id="Middle Name (optional) 2"]

[field id="Last Name 2"]

[field id="Relationship to Corporation"]

[field id="Email Address 2"]

[field id="Phone Number (optional)"]

[field id="Date of Submission"]