Appendix 5 - Community

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Instructions

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Doc5 - Appendix 5 – Ownership Information

The information provided for each of the columns in the tables below must be complete.

Name of the Licensee: ___________________________

5.1 Directors and Chief Executive Officer (CEO) (or similar)

  1. Provide a list of the directorsFootnote 1 or, where the corporation has no directors, a list of persons performing functions that are similar to the functions performed by directors, such as members of the management committee of a partnership.
  2. Provide information on the CEO. If such a position does not exist, identify the person who performs functions that are similar to those of a CEO and identify the title of that position. If the CEO is also a director, repeat the information in both sections.
Table A – Directors and CEO (or similar)

Name
City & Province of Ordinary Residence
(P.O. box not accepted)
CanadianFootnote 2
(y/n)
Directors
     
     
     
Chief Executive Officer (CEO)
     

Definitions

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