Schedule I - Ownership Corporations Returns Act

Please verify the corporate name and address and correct where needed.

• : Corporate name:
  Address (number and street):
  City:
  Province, territory or state:
  Postal or ZIP code:
  Country:

Please verify the mailing address and correct where needed.

• : Attention of:
  Address (number and street):
  City:
  Province, territory or state:
  Postal or ZIP code:
  Country:

3 - Reporting period - Question identifier:1.

Please verify, correct or provide the fiscal year-end for "company name".

Fiscal year-end (YYYY-MM-DD):

4 - Legal Status Change - Question identifier:2.

Since "YYYY-MM-DD", has "company name" had a change to its legal status?

• : Yes - What changes has this corporation had?
  - Dissolution
  - Corporate Name Change
  - Amalgamation
  - Change of Jurisdiction
• : No

4 - Legal Status Change - Question identifier:3.

What is the date of dissolution for "company name" (YYYY-MM-DD)?

4 - Legal Status Change - Question identifier:4.

In order to update our records, please provide a copy of the Dissolution document for "company name".

• : Document 1
• : Document 2
• : Document 3
• : Document 4
• : Document 5

4 - Legal Status Change - Question identifier:5.

What is "company name" new corporate name?

4 - Legal Status Change - Question identifier:6.

When did this name change take place (YYYY-MM-DD)?

4 - Legal Status Change - Question identifier:7.

In order to update our records, please provide a copy of the Corporate Name Change document for "company name".

• : Document 1
• : Document 2
• : Document 3
• : Document 4
• : Document 5

4 - Legal Status Change - Question identifier:8.

How many corporations has "company name" amalgamated with?

4 - Legal Status Change - Question identifier:9.

What were the corporate names of the other corporations?

• : Corporation 1
• : Corporation 2
• : Corporation 3, etc.

4 - Legal Status Change - Question identifier:11.

What is the date of amalgamation of this corporation?

4 - Legal Status Change - Question identifier:12.

In order to update our records, please provide a copy of the Amalgamation document for "company name".

• : Document 1
• : Document 2
• : Document 3
• : Document 4
• : Document 5

4 - Legal Status Change - Question identifier:13.

What jurisdiction is "company name" now under?

4 - Legal Status Change - Question identifier:14.

What is the date of this change of jurisdiction?

4 - Legal Status Change - Question identifier:15.

In order to update our records, please provide a copy of the Change of Jurisdiction document for "company name".

• : Document 1
• : Document 2
• : Document 3
• : Document 4
• : Document 5

5 - Nature of business - Question identifier:16.

Please verify, correct or provide the primary business activity of "company name".

Primary nature of business:

6 - Corporation - Question identifier:17.

Please verify, correct or provide the date of incorporation of "company name".

Date of incorporation:

6 - Corporation - Question identifier:18.

Please verify, correct or select the act of incorporation.

• : Federal
• : Provincial
• : Outside Canada - Please specify:

6 - Corporation - Question identifier:19.

Please verify, correct or select the manner of incorporation.

• : Articles of incorporation
• : Other - Please specify:

6 - Corporation - Question identifier:20.

Please verify, correct or select the type of corporation.

• : Canadian-controlled private corporation (CCPC)
• : Other private corporation
• : Public corporation
• : Corporation controlled by a public corporation
• : Other corporation - Please specify:

6 - Corporation - Question identifier:21.

Is this corporation foreign-controlled?

• : No
• : Yes - in which country?

7 - Share capital of reporting corporation - Question identifier:22.

Our records indicate that "company name" has "x" classes of shares. Please verify the information and make corrections if required.

Share 1: "name of class"
Shares authorized:
Authorized share capital:
Votes per share:
Shares offered for public subscription in last 5 years:

Is the information above for "name of class" exact?

• : Yes, The information above is exact
• : No, This class of shares no longer exists
• : No, Update the information

7 - Share capital of reporting corporation - Question identifier:23.

Please make corrections where required.

"name of class"
Describe fully any options or other contracts attached to this class.
Examples: common shares, preferred shares, etc.

Class of Share Name:

Number of shares authorized

• : Unlimited
• : Limited - Number of shares authorized:

Amount of authorized share capital

• : Unlimited
• : Limited - Amount of authorized share capital (in $):

Voting rights

• : Shares with voting rights - Number of votes per share
• : Shares without voting rights

Number of shares offered for public subscription in last 5 years:

7 - Share capital of reporting corporation - Question identifier:24.

Has "company name" issued other classes of shares?

• : Yes - How many other classes of shares has this corporation issued?
  Number of classes of shares:
• : No

7 - Share capital of reporting corporation - Question identifier:25.

Please provide the requested information for each class of shares.
List classes of shares having voting rights first.

New Share 1
Describe fully any options or other contracts attached to this class.
Examples: common shares, preferred shares, etc.

Class of Share Name:

Number of shares authorized

• : Unlimited
• : Limited - Number of shares authorized:

Amount of authorized share capital

• : Unlimited
• : Limited - Amount of authorized share capital (in $):

Voting rights

• : Shares with voting rights - Number of votes per share
• : Shares without voting rights

Number of shares offered for public subscription in last 5 years:

7 - Share capital of reporting corporation - Question identifier:26.

Please indicate if any of "company name" shares are held or owned in the following countries:

Country X

• : Yes, held or owned
• : No, not held nor owned

Country Y

• : Yes, held or owned
• : No, not held nor owned

Country Z

• : Yes, held or owned
• : No, not held nor owned

7 - Share capital of reporting corporation - Question identifier:27.

Are any of this corporation's shares held or owned in other countries?

• : Yes - How many other countries? :
• : No

7 - Share capital of reporting corporation - Question identifier:28.

Please indicate in which countries "company name" shares are held or owned.

• : New Country 1:
• : New Country 2:

7 - Share capital of reporting corporation - Question identifier:29.

Please verify the total number of shares held or owned in each country and make corrections if required.

Class of share 1

• : Country 1 - Number of shares:
• : Country 2 - Number of shares:
• : Country 3 - Number of shares:
  Etc.
• : Total number of shares:

Class of share 2

• : Country 1 - Number of shares:
• : Country 2 - Number of shares:
• : Country 3 - Number of shares:
  Etc.
• : Total number of shares:

Class of share 3

• : Country 1 - Number of shares:
• : Country 2 - Number of shares:
• : Country 3 - Number of shares:
  Etc.
• : Total number of shares:

7 - Share capital of reporting corporation - Question identifier:30.

For the new classes of shares indicated, provide the total number of shares held in each country.

New Class of share 1

• : Country 1 - Number of shares:
• : Country 2 - Number of shares:
• : Country 3 - Number of shares:
  Etc.
• : Total number of shares:

8 - Corporation directors and officers - Question identifier:31.

Provide the names of directors and officers that were in position for "company name" as of "YYYY-MM-DD".

8 - Corporation directors and officers - Question identifier:32.

What is JANE DOE's principal place of residence?

City:
Province/Territory/State:
Postal Code/ZIP Code:
Country:

8 - Corporation directors and officers - Question identifier:33.

Is JANE DOE a director?

• : Yes
• : No

8 - Corporation directors and officers - Question identifier:34.

What is the main position held by JANE DOE?

Position:

8 - Corporation directors and officers - Question identifier:35.

What is JANE DOE's citizenship?

Citizenship:

8 - Corporation directors and officers - Question identifier:36.

Does JANE DOE own shares of this corporation?

• : Yes
• : No

8 - Corporation directors and officers - Question identifier:37.

Please verify, correct or provide the number of shares owned by each corporate director and officer.

JANE DOE
Canada
Class of share #1 - Number of shares:
Class of share #2 - Number of shares:
Class of share #3 - Number of shares:

JOHN DOE
Canada
Class of share #1 - Number of shares:
Class of share #2 - Number of shares:
Class of share #3 - Number of shares:

8 - Corporation directors and officers - Question identifier:38.

Are any of "company name" directors or officers part of a related group?

• : Yes - How many related groups are there?
• : No

8 - Corporation directors and officers - Question identifier:39.

Please select the related group for each director or officer.

JANE DOE

• : Related Group 1
• : Related Group 2
• : Not part of a related group

JOHN DOE

• : Related Group 1
• : Related Group 2
• : Not part of a related group

9 - Ownership of share capital of the reporting corporation - Question identifier:40.

Please list the corporations, individuals or related groups that own or hold 10% or more of the total issued shares of any class of shares, and not accounted for in Question 37.

9 - Ownership of share capital of the reporting corporation - Question identifier:41.

Please verify the address for "New#1" and make corrections if required.

Address (number and street):
City:
Province, territory or state:
Postal or ZIP code:
Country:

9 - Ownership of share capital of the reporting corporation - Question identifier:42.

Does "New#1" have a principal place of business in Canada?

• : Not applicable
• : No
• : Yes - What is the address of "New#1" principal place of business in Canada?
  
  - Address (number and street):
  - City:
  - Province or Territory:
  - Postal Code:

9 - Ownership of share capital of the reporting corporation - Question identifier:43.

Please verify, correct or provide the number of shares owned by each corporation, individual or related group.

Company #1
Class of share #1 - Number of shares:
Class of share #2 - Number of shares:
Class of share #3 - Number of shares:

Company #2
Class of share #1 - Number of shares:
Class of share #2 - Number of shares:
Class of share #3 - Number of shares:

Company New#1
Class of share #1 - Number of shares:
Class of share #2 - Number of shares:
Class of share #3 - Number of shares:

10 - Related Groups - Question identifier:44.

Is any individual listed in the summary, part of a related group?

• : Yes - How many related groups are there?
• : No

10 - Related Groups - Question identifier:45.

Please verify, correct or select the related group for each individual.

JANE DOE

• : Related Group 1
• : Related Group 2
• : Not part of a related group

JOHN DOE

• : Related Group 1
• : Related Group 2
• : Not part of a related group

11 - Other Shareholders - Question identifier:46.

Are there any shareholders who own or hold more than 5% but less than 10% of the total issued shares of any class, with addresses outside Canada or no address of record and not specified in previous questions?

• : Yes - How many shareholders are there?
• : No

11 - Other Shareholders - Question identifier:47.

Please verify, correct or indicate shares owned or held by each shareholder.

Shareholder #1
Class of share #1 - Number of shares:
Class of share #2 - Number of shares:
Class of share #3 - Number of shares:

12 - Share capital of corporations owned by reporting corporation - Question identifier:48.

Please list the name of each corporation authorized to do business in Canada of which "company name" owns 10% or more of the voting shares that can elect directors.

Remove or Add names as appropriate.

Corporation
• Company A (*Remove)
• Company B (*Remove)

Add a corporation
• Name:

12 - Share capital of corporations owned by reporting corporation - Question identifier:49.

Please verify, correct or complete the address of "New#1" Head office.

• Street name and number:
• City:
• Province/Territory:
• Postal Code:

12 - Share capital of corporations owned by reporting corporation - Question identifier:50.

Please verify, correct or select the manner of incorporation.

• : Articles of incorporation
• : Other - Please specify:

12 - Share capital of corporations owned by reporting corporation - Question identifier:51.

Please verify, correct or provide the date of incorporation.

Date :

12 - Share capital of corporations owned by reporting corporation - Question identifier:52.

Please verify, correct or specify the place of incorporation.

12 - Share capital of corporations owned by reporting corporation - Question identifier:53.

Please verify, correct or specify the percentage owned directly.

Percentage:

12 - Share capital of corporations owned by reporting corporation - Question identifier:54.

Not applicable. Question removed.

13 - Funded debt of reporting corporation - Question identifier:55.

Does "company name" have any new classes of debentures?

• : Yes - How many? :
• : No

13 - Funded debt of reporting corporation - Question identifier:56.

For "company name", list all classes of debentures including bonds, debenture stock and any other forms of funded debt. Exclude: bank loans, inter-company loans, director's loans, etc.

Class of debentures #1
• Class of funded debt:
• Description of each issue:
• Total value of issued and outstanding debentures (in $):
• Total amount offered for public subscription in Canada in last 5 years for each issue (in $):

14 - Contact person - Question identifier:57.

Statistics Canada may need to contact the person who completed this return for further information. Please complete the information below for the best person to contact about this return.

• First name:
• Last name:
• Title:
• Email address:
• Telephone number (including area code):
• Extension number (if applicable):
• Fax number (including area code):

• : I certify that the information herein is complete and correct to the best of my knowledge.

15 - Consent to pre-fill information - Question identifier:58.

Do you agree to let Statistics Canada pre-fill parts of the next return for the next reporting period?

• : Yes, I agree to pre-fill the next return.
• : No, start with a blank return.

16 - Additional contact persons - Question identifier:59.

Please provide the names of two additional contact persons. Statistics Canada may need to validate or confirm some of the information received. The first additional contact person must be the President or Vice-President of the corporation filing the return, while the second contact person can be one other officer thereof or another person duly authorized by the board of directors to act on behalf of the corporation.

If you are filing on behalf of a third party (client) corporation, the second additional contact person can be from your firm.

First additional contact person
• First name:
• Last name:
• Position or rank of officer:
• Email address:
• Telephone number (including area code):

Second additional contact person
• First name:
• Last name:
• Position or rank of officer:
• Email address:
• Telephone number (including area code):

17 - Comments - Question identifier:60.

How long did it take to complete this return?

• Hours:
• Minutes:

17 - Comments - Question identifier:61.

Statistics Canada reviews all feedback. We invite your comments about this return.

As stated in Section 16 of the Corporations Returns Act, the information contained in this return is not confidential. The data is available in the Inter-Corporate Ownership product.

If you are ready to submit your return, press the Submit button.