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To: Executive Director, Alberta Securities Commission (ASC)
I am filing this report in compliance with the dealer registration exemption in ASC Blanket Order 31-536 Alberta Small Business Finder’s Exemption.
If you select Yes to the question below, the individual information section will be displayed. If you select No, you will be submitting the form as a Company and the company information section will be displayed.
My full legal name is:
I am also known as:
My residential address is (do not include a P.O. box or agent for service):
If No, complete the following:
Full legal name of Company1, relying on ASC Blanket Order 31-536
The Company’s street address is (do not include a P.O. box or agent for service):
1A company is only permitted to rely on the exemption if its only registered and beneficial shareholders are an individual Finder or the individual Finder’s spouse, alone or together.
I am the individual responsible for ensuring compliance with ASC Blanket Order 31-536 and for filing and updating the information reports for the Company and I can be contacted with respect to any questions regarding the contents of this report
The personal information submitted in this report is collected on behalf of and used by the Alberta Securities Commission under the authority granted in securities legislation for the purposes of its administration and enforcement of the securities legislation.
If you have any questions about the collection and use of your personal information, you can contact the Alberta Securities Commission, at the address listed below.
Alberta Securities Commission
Suite 600, 250-5th St. SW
Calgary, AB T2P 0R4
Attention: FOIP Coordinator
Telephone: (403) 297-6454
Toll free in Canada: 1-877-355-0585