OSI Registration Request Form - X400 ADMD AND PRMD

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Provision of the information is on a voluntary basis. We will use the information for the purpose of responding to your questions/comments, and to improve our Internet presence.

The information will be held in Public Works and Government Services Canada's Personal Information Bank number PPU 115 (Internet Services), and it will be retained according to the retention and disposal schedule established for this bank.

Your personal information is protected under the provisions of the Privacy Act. Under the Act, you have the right to request access to and correction of your personal information, if erroneous or incomplete.

For more information about your rights, see Info Source. This is a Government of Canada publication available in major libraries, at government information offices and from constituency offices of federal Members of Parliament.

Registration Action:

	New Application
	Record Change
	Deactivation
	Activation

Name of Organization OR Address Values:

PRMD NAME (16 characters max)

This name is being registered as:

	ADMD
	PRMD
	PRMD prefix

Note: If you are registering an ADMD name and have not been authorized by the Canadian National Organization for the International Telecommunication Union-Telecommunication Standardization (CNO/ITU-TS) to operate the ADMD, you must complete and submit an application for authorization to operate an ADMD. COSIRA will forward the application to CNO/ITU-TS.

Do you wish to restrict publication of the information in this application ?
If you wish to restrict publication information, only your OSI alphanumeric and numeric name value(s) and registration date will be published.

	Yes
	No

Please be sure to fill in the OSI Registration Request Form - General Information Forms. Your application cannot be processed without them.