FEDERAL INCORPORATION QUESTIONNAIRE Please enable JavaScript in your browser to complete this form.Client InformationFirst Name *Last Name *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodePhoneEmail *Responsible Lawyer (if known)Dana GordonSamuel SukSilas PolkinghorneSean XuPlease attach a copy of your driver's license, BC Services Card or other photo ID * Click or drag a file to this area to upload. Company NameNUANS Reservation Number (if reserved)Name ChoiceCorporate DesignationInc.IncorporatedLtd.LimitedCorp.CorporationNature of BusinessCompany InformationName and Address of Additional IncorporatorsWhere would you like your registered and records office?My addressBenchmark Law Corporation - Vancouver (annual fee of $200 applies)Benchmark Law Corporation - Langley (annual fee of $200 applies)The following address:AddressAddress Line 1Address Line 2CityState / Province / RegionAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryMinute Book DeliveryI will pick up from your Vancouver officeI will pick up from your Langley officePlease courier/mail the minute book on completion (Courier/postage fees will apply)Number of Directors *OneTwoThreeMore than threeName of Director #1Address of Director #1 (if different than Incorporator)Email of Director #1 (if different than Incorporator)Name of Director #2Address of Director #2Email of Director #2Name of Director #3Address of Director #3Email of Director #3Name and Address of Additional DirectorsShare InformationNumber of Shareholders *OneTwoThreeMore than threeName and Address of Shareholder #1Percentage of OwnershipClass of SharesVoting or non-voting / Common or preferred / etc.BirthdateCountry of CitizenshipIs the shareholder a Canadian resident for tax purposes?YesNoName and Address of Shareholder #2Percentage of Ownership Class of Shares Voting or non-voting / Common or preferred / etc.BirthdateCountry of Citizenship Is the shareholder a Canadian resident for tax purposes? YesNoName and Address of Shareholder #3Percentage of OwnershipClass of SharesVoting or non-voting / Common or preferred / etc.BirthdateCountry of Citizenship Is the shareholder a Canadian resident for tax purposes? YesNoAdditional Shareholder InformationAdditional Information (optional)Submit
