Program Development & Evaluation Branch 1201 Wilson Avenue Downsview ON M3M 1J8
The IRP agreement requires carriers to maintain an Established Place of Business or reside in the jurisdiction where they base plate. This form must be completed and back-up documentation provided prior to prorate registration in accordance with IRP Plan, Sections 305 – Selection of Base Jurisdiction and the definition of Established Place of Business.
Name of Company or Registrant (print):
Unit No. Street No. Street Name PO Box City/Town Province Postal Code
If yes, where?
2. What are your business hours?
If no, where?
Last Name First Name Middle Initial
You must include at least 3 of the following back-up documents:
I/we, the undersigned, do hereby certify, that the statements made herein are true and correct.
Signature of Registrant Date (YYYY/MM/DD)