Transparency Register Form

The Transparency Register is a new requirement in BC. To streamline the process, Open Door Law has created a fillable form for our clients to complete and return to us so that we may assist them with meeting the new requirements. Our law firm will rely on the information you provide to create the register for insertion into your corporation’s minute book. Please ensure that you are candid and accurate.

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If you would rather complete this form on paper, we also offer a PDF version that you can print, then mail or fax to us. (Details within)

    Fields marked with * are required

    A. Company Information

    B. Significant Individual(s) Information

    Number of Significant Individuals:

    Significant Individual 1

    Is this significant individual a Canadian citizen or permanent resident? *YesNo

    Is this significant individual a Canadian resident for tax purposes? *The individual has residential ties in Canada, or resides in Canada for at least 183 days per year.YesNo

    **This will be the date you first became a shareholder as set out in the Central Securities Register (unless you were not initially a significant individual but gradually acquired more shares, interests, rights, or abilities over time, which caused you to become a significant individual at a later date). If you became a SI upon the incorporation of the company, please enter the date of incorporation. You can find the incorporation date by searching for your company at Canada’s Business Registries. Contact us if you require further assistance in determining the correct date, or an updated copy of your Central Securities Register.

    I am a Significant Individual of the Company because: *(Please select one option ONLY. (e.g. if you are a significant individual because you are registered as a shareholder of the company, you should select “Registered Owner” and provide your share percentage when prompted.))Registered Owner - I am the Registered Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyBeneficial Owner - I am the Beneficial Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyRight to Elect - I have the right to elect, appoint, or remove the majority of the directors of this companyIndirect Control - I control an intermediary which is the registered owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this company OR which has the right to elect, appoint, or remove the majority of the directors of this companyCombination of Interests - I have a combination of interests, rights, or abilities that (when added together)Direct and Significant Influence - I have direct and significant influence over an individual that has the right to elect, appoint, or remove the majority of the directors of this companyActing in Concert - I have interests, rights, or abilities that, when combined with those of my spouse, parents, children, relatives who share the same home, or one or more other persons with whom I am acting in concertOtherI believe that I am NOT a Significant Individual of the Company

    Please check: VotesShares

    Please check: VotesShares

    The intermediary is a/an: Corporation in which I have the right to elect or appoint a majority of the directorsPartnership in which I am a partner (including limited and limited liability partners)Agent of whom I am the principalTrustee whom I controlPersonal or other legal representative whom I control

    Please specify: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: None of the statements listed above applies to meOther

    Please confirm the following statements are true: I do not hold shares in trust, as agent, or as personal or other legal representative, for another personNo other person can direct my decision making or influence my decision making

    Significant Individual 2

    Is this significant individual a Canadian citizen or permanent resident? YesNo

    Is this significant individual a Canadian resident for tax purposes? The individual has residential ties in Canada, or resides in Canada for at least 183 days per year.YesNo

    I am a Significant Individual of the Company because: *Registered Owner - I am the Registered Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyBeneficial Owner - I am the Beneficial Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyRight to Elect - I have the right to elect, appoint, or remove the majority of the directors of this companyIndirect Control - I control an intermediary which is the registered owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this company OR which has the right to elect, appoint, or remove the majority of the directors of this companyCombination of Interests - I have a combination of interests, rights, or abilities that (when added together)Direct and Significant Influence - I have direct and significant influence over an individual that has the right to elect, appoint, or remove the majority of the directors of this companyActing in Concert - I have interests, rights, or abilities that, when combined with those of my spouse, parents, children, relatives who share the same home, or one or more other persons with whom I am acting in concertOtherI believe that I am NOT a Significant Individual of the Company

    Please check: VotesShares

    Please check: VotesShares

    The intermediary is a/an: Corporation in which I have the right to elect or appoint a majority of the directorsPartnership in which I am a partner (including limited and limited liability partners)Agent of whom I am the principalTrustee whom I controlPersonal or other legal representative whom I control

    Please specify: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: None of the statements listed above applies to meOther

    Please confirm the following statements are true: I do not hold shares in trust, as agent, or as personal or other legal representative, for another personNo other person can direct my decision making or influence my decision making

    Significant Individual 3

    Is this significant individual a Canadian citizen or permanent resident? YesNo

    Is this significant individual a Canadian resident for tax purposes? The individual has residential ties in Canada, or resides in Canada for at least 183 days per year.YesNo

    I am a Significant Individual of the Company because: *Registered Owner - I am the Registered Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyBeneficial Owner - I am the Beneficial Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyRight to Elect - I have the right to elect, appoint, or remove the majority of the directors of this companyIndirect Control - I control an intermediary which is the registered owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this company OR which has the right to elect, appoint, or remove the majority of the directors of this companyCombination of Interests - I have a combination of interests, rights, or abilities that (when added together)Direct and Significant Influence - I have direct and significant influence over an individual that has the right to elect, appoint, or remove the majority of the directors of this companyActing in Concert - I have interests, rights, or abilities that, when combined with those of my spouse, parents, children, relatives who share the same home, or one or more other persons with whom I am acting in concertOtherI believe that I am NOT a Significant Individual of the Company

    Please check: VotesShares

    Please check: VotesShares

    The intermediary is a/an: Corporation in which I have the right to elect or appoint a majority of the directorsPartnership in which I am a partner (including limited and limited liability partners)Agent of whom I am the principalTrustee whom I controlPersonal or other legal representative whom I control

    Please specify: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: None of the statements listed above applies to meOther

    Please confirm the following statements are true: I do not hold shares in trust, as agent, or as personal or other legal representative, for another personNo other person can direct my decision making or influence my decision making

    Significant Individual 4

    Is this significant individual a Canadian citizen or permanent resident? YesNo

    Is this significant individual a Canadian resident for tax purposes? The individual has residential ties in Canada, or resides in Canada for at least 183 days per year.YesNo

    I am a Significant Individual of the Company because: *Registered Owner - I am the Registered Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyBeneficial Owner - I am the Beneficial Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyRight to Elect - I have the right to elect, appoint, or remove the majority of the directors of this companyIndirect Control - I control an intermediary which is the registered owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this company OR which has the right to elect, appoint, or remove the majority of the directors of this companyCombination of Interests - I have a combination of interests, rights, or abilities that (when added together)Direct and Significant Influence - I have direct and significant influence over an individual that has the right to elect, appoint, or remove the majority of the directors of this companyActing in Concert - I have interests, rights, or abilities that, when combined with those of my spouse, parents, children, relatives who share the same home, or one or more other persons with whom I am acting in concertOtherI believe that I am NOT a Significant Individual of the Company

    Please check: VotesShares

    Please check: VotesShares

    The intermediary is a/an: Corporation in which I have the right to elect or appoint a majority of the directorsPartnership in which I am a partner (including limited and limited liability partners)Agent of whom I am the principalTrustee whom I controlPersonal or other legal representative whom I control

    Please specify: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: None of the statements listed above applies to meOther

    Please confirm the following statements are true: I do not hold shares in trust, as agent, or as personal or other legal representative, for another personNo other person can direct my decision making or influence my decision making

    Significant Individual 5

    Is this significant individual a Canadian citizen or permanent resident? YesNo

    Is this significant individual a Canadian resident for tax purposes? The individual has residential ties in Canada, or resides in Canada for at least 183 days per year.YesNo

    I am a Significant Individual of the Company because: *Registered Owner - I am the Registered Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyBeneficial Owner - I am the Beneficial Owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyRight to Elect - I have the right to elect, appoint, or remove the majority of the directors of this companyIndirect Control - I control an intermediary which is the registered owner of shares that carry 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this company OR which has the right to elect, appoint, or remove the majority of the directors of this companyCombination of Interests - I have a combination of interests, rights, or abilities that (when added together)Direct and Significant Influence - I have direct and significant influence over an individual that has the right to elect, appoint, or remove the majority of the directors of this companyActing in Concert - I have interests, rights, or abilities that, when combined with those of my spouse, parents, children, relatives who share the same home, or one or more other persons with whom I am acting in concertOtherI believe that I am NOT a Significant Individual of the Company

    Please check: VotesShares

    Please check: VotesShares

    The intermediary is a/an: Corporation in which I have the right to elect or appoint a majority of the directorsPartnership in which I am a partner (including limited and limited liability partners)Agent of whom I am the principalTrustee whom I controlPersonal or other legal representative whom I control

    Please specify: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: Amount to 25% or more of the voting rights OR 25% or more of the total issued shares (voting plus non-voting) of this companyEntitle me to elect, appoint, or remove the majority of the directors of this company

    Please select: None of the statements listed above applies to meOther

    Please confirm the following statements are true: I do not hold shares in trust, as agent, or as personal or other legal representative, for another personNo other person can direct my decision making or influence my decision making

    Five or more Significant Individuals

    C. Additional Information

    Additional Comments (if any):

    I confirm that Open Door Law Corporation is to create the Company's Transparency Register on my behalf and I agree to pay all legal fees, taxes and disbursements associated with the transparency register. I further confirm that all information provided is true and accurate to the best of my knowledge.


    Required Consent and Agreement *

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