Name, or proposed name, of Canadian business being established
10.
Business address of the Canadian business being established (if not yet determined, city and province in Canada)
11.
Brief description of the business activities of the Canadian business being established (e.g. manufacturing clothing, wholesaling food, etc.)
12 to 16 do not apply to the establishment of a new Canadian business - go to 17
17.
a) Projected number of persons to be employed in connection with the new Canadian business at the end of the second full year of operation:
1 to 10
10 to 49
50 to 199
If 200 or more, please specify
b) Projected total amount of Canadian dollars to be invested in the new Canadian business during the first two years of operation:
under $500 000
0.5M to $2M
$2M to $5M
if over $5M, please specify:
c) Projected level of annual sales or revenues of the new Canadian business during the second full year of operation:
under $500 000
0.5M to $2M
$2M to $5M
if over $5M, please specify:
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 that 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 APPLIC ABLE. 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
e) does not apply to the establishment of a new Canadian business - continue
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
Investment Canada Act
