If more than one entity is acquired, provide the information in 9, 10 and 11 for eachentity being acquired - please itemize
9.
Name(s) of the Canadian business(es) being acquired
10.
Business address(es) of the Canadian business(es)
11.
Brief description of the business activities of the Canadian business(es) (e.g. manufacturing clothing, wholesaling food, etc.)
12.
If the investor is not a WTO investor or a NAFTA investor, is the Canadian business,
immediately prior to the implementation of the investment, "controlled by a WTO investor or a NAFTA investor"?
Yes
No
13.
If the investor is a WTO investor or a NAFTA investor, OR if the Canadian business is,
immediately prior to the implementation of the investment, "controlled by a WTO investor or a NAFTA investor," indicate whether the Canadian business:
a) engages in the production of uranium and owns an interest in a producing uranium property in Canada
b) provides any service of a financial nature offered by a financial institution (excluding the underwriting and selling of insurance policies)
c) provides any transportation service
d) is a cultural business as referred to in item 18, or a business involving radio communication in which
the transmissions are intended for direct reception by the general public, any radio, television and cable television
broadcasting undertakings and any satellite programming and broadcast network services
14.
Where the Canadian business is, immediately prior to the implementation of the investment controlled outside of Canada, indicate
the country of control (ultimate control)
a) Give the value of all assets of the entity carrying on the Canadian business and of all other
entities in Canada control of which is being acquired in this transaction, or if purchasing
assets, give the total value of all assets of the Canadian business being acquired:
AND
b) If the acquisition of the Canadian business is the result of the acquisition of control of a
corporation incorporated outside Canada, give the total value of the assets of all entities
both in Canada and outside Canada, the control of which is being acquired in this transaction
THE VALUE OF ASSETS IS THE VALUE SHOWN IN THE APPLICABLE FINANCIAL STATEMENTS, EXPRESSED IN CANADIAN DOLLARS
17.
does not apply to acquisitions - go to question 18
CANADIAN CULTURAL HERITAGE OR NATIONAL IDENTITY
18.
a) Indicate if the investment falls within any of the following business activities:
Publication, distribution or sale of books, magazines, periodicals or newspapers in print or
machine readable form (other than the sole activity of their printing or typesetting)
Production, distribution, sale or exhibition of film or video recordings
Production, distribution, sale or exhibition of audio or video music recordings
Publication, distribution or sale of music in print or machine readable form
IF YOU HAVE CHECKED OFF ANY OF THE ABOVE ACTIVITIES, PROVIDE THE FOLLOWING INFORMATION, WHERE APPLICABLE. YOU MAY USE APPLICABLE ANNUAL REPORTS, OTHER BUSINESS MATERIAL, OR A SEPARATE ATTACHMENT TO ANSWER ITEMS b) to d):
b) a description of the business activities of the investor
c) a description of any business activity carried on by the person or entity that controls the investor, if any, that is similar to those indicated in a)
d) a description of any products manufactured or sold, or to be manufactured or sold, and of any services rendered, or to be rendered, by the Canadian business
IF YOU AREUNABLE TO ANSWER ANY OF THE QUESTIONS RELEVANT TO YOUR INVESTMENT, INDICATE THE REASONS
Date
Signature of Investor
Name and Title
Please send this form to:
Industry Canada
Director of Investments
235 Queen Street, Room 301B East Tower
C.D. Howe Building
Ottawa, Ontario
K1A 0H5
FAX (613) 996-2515
Investment Canada Act
