Ownership and Control Affidavit Template

DECLARATION RE : CANADIAN TELECOMMUNICATIONS COMMON CARRIER OWNERSHIP AND CONTROL REGULATIONS

CANADA IN THE MATTER OF ___________________ , [Entity Name]

Re : Canadian Telecommunications Common Carrier
Ownership and Control Regulations, s. 16
Telecommunications Act R.S.C., c.38

I,____________________ [Name] the duly appointed _________________________ [Title]
of ___________________________________________ [Entity Name] do SOLEMNLY
DECLARE that ___________________________________[Entity Name] is eligible to operate as a telecommunications common carrier pursuant to s.16 of the Telecommunications Act R.S.C. 2012, c. 38 as [check one of the following]

(  ) a Canadian owned and controlled entity continued under the laws of Canada or a province eligible under section 2(a);
(  ) an entity which owns and/or operates only transmission facility or facilities referred to in subsection (5);
(  ) whose annual revenues from the provision of telecommunications services in Canada, together with that of its affiliates, represent less than 10% of total Canadian telecommunications revenues, eligible under section 2(c);

AND I DECLARE that ___________________________________[Entity Name] is a

(  ) a corporation, with or without share capital;
(  ) a partnership;
(  ) a trust; or
(  ) a joint venture
as defined in s.16(1) of the Telecommunications Act R.S.C. 2012, c. 38

AND I also DECLARE that the following are my affiliates, as defined in s.35(3) of the Telecommunications Act R.S.C. 2012, c. 38,:
________________________________________________________________
________________________________________________________________

________________________________________________________________;

AND I also DECLARE, pursuant to the Canadian Telecommunications Common Carrier Ownership and Control Regulations, that:

AND I make this solemn Declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath.
DECLARED before me at _________ [City]
Province of __________
This ____ [Day] of _____ [Month], ______ [Year]
 
___________________________[Signatory]
 
_________________________________
[A COMMISSIONER OF OATHS]

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