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Application to Obtain a Broadcasting Licence to Operate a Distribution Undertaking - Form 124General instructionsFilingFile electronically via Access Key by attaching the application to the Cover page. Access Key allows secure transmissions to the Commission and also authenticates your identity. Therefore, a signature is not required. Applicants who file their application in this manner are not required to submit a hard copy of the application and its related documents. Applicants who cannot send their application electronically with the Access Key service or who need further information relative to the CRTC processes can contact the Commission at 1-877-249-CRTC (2782). InstructionsThe following questionnaire is in HTML format and may be downloaded to the word processing software of your choice. This enables you to complete the downloaded questionnaire by inserting your response in bold letters immediately following the question. You may add lines to the tables if necessary but do not alter or delete any text from the questionnaire. The application must be divided into sections as set out in the questionnaire, and include the numbered questions followed by the corresponding response. Responses must be provided, at a minimum, in a size 10 font. Naming convention for the electronic documentsThe following documents should be submitted as separate electronic documents using the naming convention specified below. The document number (Doc#) indicates the ascending order in which the documents should appear on the public file. Table 1 - Naming convention for the electronic document |
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| The Commission may return the application if it has not been duly completed or if the required technical documentation has not been filed with Industry Canada. The onus will be on the applicant to submit a clear application that provides all of the relevant information, identifies all regulatory issues raised in the application and provides supporting documentation. |
Canadian Radio-television and Telecommunications CommissionForm 124 - Application to Obtain a Broadcasting Licence to Carry on a Distribution Undertaking1. General information |
| Location of undertaking:________________________________________________________ |
| TYPE OF UNDERTAKING | NUMBER OF SUBSCRIBERS |
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| Cable | Class 1 ( ) | Class 2 ( ) | Class 3 ( ) | |
| Radiocommunication (off-air): |
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| MDS | Class 1 ( ) | Class 2 ( ) | Class 3 ( ) | |
| LMCS | Class 1 ( ) | Class 2 ( ) | Class 3 ( ) | |
| MTV (unscrambled) ( ) | ||||
| STV (scrambled) ( ) | ||||
| Satellite: |
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| DTH ( ) | ||||
| Other ( ) Specify: |
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1.1 |
Identification of proposed licensee (hereinafter the applicant) |
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| Individual ( ) | Company to be incorporated ( ) |
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| Company ( ) | Other ( ) Specify: ____________________ |
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Name: Address: Fax: E-mail: Contact person representing the applicant Name: |
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| 1.2 |
Appointment of agent I, _________________________, the applicant, hereby appoint _____________________ as my agent for and on my behalf and in my name to sign, file and complete (if necessary) an application with the Canadian Radio-television and Telecommunications Commission and to sign and file a reply with respect thereto and I do hereby ratify, confirm, and adopt as my own act, such application and all replies made thereto. Date: |
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| 1.3 | Declaration of applicant or its appointed agent |
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| I, ___________________________________ SOLEMNLY DECLARE THAT: |
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| a) | I am the ___________________________ (representative/appointed agent) of the applicant named in this Application Brief and as such have knowledge of all matters declared therein. |
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| b) | The statements made in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) to the best of my knowledge and belief true in all respects. |
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| c) | The opinions and estimates given in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) based on facts as known to me. |
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| d) | I have examined the provisions of the Broadcasting Act and the broadcasting regulations relevant to this application. |
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And I have signed Signature: Date: Witnessed by Signature: Name (Printed): Date: At: |
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| 1.4 |
Location(s) where the application may be examined
Set out the applicant’s website address or, if the application is not posted on their website, the email address where an electronic copy of the application may be requested: Website: Email: |
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1.5 |
Procedural requestThe Canadian Radio-television and Telecommunications Commission Rules of Practice and Procedure allow an interested person to request that the Commission exercise a power under the Rules of Procedure or change the Rules of Procedure for a specific proceeding (sections 5 and 7). This is generally called a procedural request. You may consult the Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and the Guidelines on the CRTC Rules of Practice and Procedure, Broadcasting and Telecom Information Bulletin CRTC 2010-959, 23 December 2010, for more information. |
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2. Ownership
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Definitions:(1) NAME/SHAREHOLDER: If any of these persons hold public office, by election or appointment, indicate the office held under the name of the person(s). |
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2.1 For the applicant, complete the following tables providing: |
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| a) | A list of the directors and officers, including the Chief Executive Officer. |
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Name of the corporation for which the following table pertains: |
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DIRECTORS AND OFFICERS |
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Name(1) |
Complete Home |
Citizenship(2) |
Directors(3): |
Officers(4): |
b) |
A list of shareholders holding 10% or more of the voting shares(6), of the voting rights (when different from the voting shares), and of the Common(7) (participating) shares, by class of shares. |
| Name of the corporation for which the following table pertains: | ||||||||
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CAPITAL STRUCTURE AND SHAREHOLDERS |
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Shares/ |
Participating |
Votes |
Authorized |
Issued |
Name of Shareholders(1) |
No. |
% of |
Canadian |
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c) |
A breakdown between Canadian and non-Canadian of the remaining shares not accounted for in b), by class of shares. |
| Name of the corporation for which the following table pertains: | ||||
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Class of Shares |
Shareholders |
Total Number of Shares |
% of Votes |
Canadian(2)(5) |
2.2 |
Complete the following tables for each corporation holding, directly and/or indirectly, 20% or more of the voting interest (shares and/or votes) of the licensee: |
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| a) | A list of the directors and officers of the corporation, including the Chief Executive Officer. |
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Name of the corporation for which the following table pertains: |
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DIRECTORS AND OFFICERS |
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Name(1) |
Complete Home Address |
Citizenship(2) |
Directors(3):
Date of |
Officers(4): |
b) |
A list of shareholders holding 10% or more of the voting shares(6), of the voting rights (when different from the voting shares), and of the Common(7) (participating) shares, by class of shares. |
| Name of the corporation for which the following table pertains: | ||||||||
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CAPITAL STRUCTURE AND SHAREHOLDERS |
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Shares/ |
Partici- |
Votes |
Authorized |
Issued |
Name of Shareholders(1) |
No. |
% of |
Canadian(2)(5) |
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c) |
A breakdown between Canadian and non-Canadian of the remaining shares not accounted for in b), by class of shares. |
| Name of the corporation for which the following table pertains: | ||||
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Class of Shares |
Shareholders |
Total Number of |
% of |
Canadian(2)(5) |
2.3 |
Complete the same tables as in 2.2 for each corporation holding, directly and/or indirectly, 20% or more of the voting interest (shares and/or votes) of the corporations in 2.2 b), and for any corporation forming part of their ownership chain. |
Supporting documents to be appended:
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| Appendix 2A | A copy of all constituting documents (for example, Articles and Certificates of Incorporation, By-Laws, Partnership or Trust Agreement) relating to the applicant and each corporation or other legal entity identified in questions 2.1, 2.2 and 2.3 (provide draft documents where a corporation is not yet incorporated). If the constituting documents have been filed with the Commission and no changes have occurred since, provide reference to the application that contains the most recent documentation together with a declaration attesting that the information is still accurate and valid as of the date of the filing of the application. |
| Appendix 2B | A statement regarding who controls/will control the applicant and by what means; if control is to be held by a shareholder company, also advise who controls/will control it and by what means; if applicable, attach all related documents or agreements (for example, Shareholder Agreement, Voting Trust Agreement). |
| Appendix 2C | If the applicant has delegated or will delegate by contract any responsibility, copies of the contracts (or proposed contracts). If applicable, indicate the legislative authority under which the corporation or other legal entities to such contracts are incorporated or otherwise constituted. |
3. Industry consolidation and cross-media ownership |
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| 3.1 | Provide a list of all entities involved in any of the areas listed below, for which any investment (equity and/or debt securities) is held by the applicant, a corporation which directly or indirectly controls the applicant and any shareholder holding 20% or more of the voting shares and/or rights of the applicant: |
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| a) | Other CRTC licence holder and exempted undertakings |
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| b) | Daily newspaper |
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| c) | Non-daily newspaper or other media publisher |
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| d) | Production or distribution of programming material |
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| e) | Lessor of property, plant or equipment of applicant |
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| f) | Telecommunications company regulated under the Telecommunications Act |
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| g) | Company owning securities in any of categories (a) to (f) |
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4. Service information
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| 4.1 | a) | Have all required technical documents been filed with Industry Canada? |
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| YES ( ) | NO ( ) |
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| b) | I hereby authorize the Commission to include as part of this application any documents or correspondence filed with Industry Canada with respect to this application. |
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| YES ( ) | NO ( ) |
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| If NO, explain. |
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| 4.2 | Describe the proposed service area noting the name(s) of the principal community(ies): |
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| 4.3 | Provide the number of households within the proposed service area identified on the map provided as APPENDIX 4A. |
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Number of Households |
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| Households | |
| Households already served by an existing subscription based distribution undertaking(s) |
4.4 |
Indicate the geographical co-ordinates of the head-end (cable) or the transmitter site (radiocommunication) as well as the nominal bandwidth capacity: |
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Geographical Coordinates |
Nominal Bandwidth Capacity (MHz) | |||
| North Latitude |
deg. |
min. |
sec. |
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| West Longitude |
deg. |
min. |
sec. |
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4.5 |
Provide the proposed fees as follows: |
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Proposed Fees |
$ |
| Basic monthly fee | |
| Typical installation fee |
Distribution of services |
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| 4.6 | Provide a list of proposed services to be distributed by the distribution undertaking: |
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DISTRIBUTION OF SERVICES |
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Programming services |
Service Type |
Reception |
Mode of |
Channel or |
| 1. | ||||
| 2. | ||||
| 3. | ||||
| 4. | ||||
| 5. | ||||
Note: An applicant that is awarded a licence will be required to provide, at the same time it informs the Commission that it is ready to commence operations, a website address where its distribution grid is posted (refer to Broadcasting Information Bulletin CRTC 2009-384). |
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| 4.7 | Authorizations and/or conditions of licence are required in order to distribute certain proposed programming services listed at 4.6 - Distribution of Services: |
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| YES ( ) |
NO ( ) |
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| If YES, provide proposed wording for EACH authorization and/or condition of licence requested. |
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Locally originated programmingIn Public Notice CRTC 1997-25 entitled New Regulatory Framework for Broadcasting Distribution Undertakings, the Commission indicated that it intended to give all terrestrial distributors the opportunity to present innovative proposals for providing outlets for local expression within the purview of the Act. In addition, the Commission noted that the appropriateness of a distributor's proposal as a means of providing local expression would be assessed at the time of licensing or the licence renewal process. 4.8 In the event that no locally originated programming is proposed or that the proposed local expression initiatives are not eligible, confirm that a contribution
Yes ( ) No ( ) |
Where locally originated programming will be provided, please respond to questions 4.9 to 4.12. |
| 4.9 Provide a brief description of the type of local expression initiatives which would be distributed: |
| 4.10 Language of locally originated programming: |
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English ( )
French ( ) Other (
) Specify:_______________________________ |
| 4.11 Is the local programming to be shared on a channel with another service: |
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Yes ( ) No ( ) |
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If YES, specify: |
| 4.12 Where locally originated programming is proposed, provide a brief description of: |
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Paragraph 90 of Broadcasting Regulatory Policy
CRTC 2010-622, states that the Commission expects licensed
BDUs to ensure that 100% of original access programming is captioned by the end of the next licence term.
Please describe how the licensee will ensure that 100% of original
access programming is captioned by the end of the new licence term.
4.18 Please describe any other mechanisms designed to make your services more accessible for people with disabilities.
Supporting document to be appended:
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Appendix 4A |
Proposed service area (refer to Broadcasting Information Bulletin CRTC 2009-384) |
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| a) |
For cable distribution undertakings, provide a service area map that reflects the boundaries of the proposed service area in one of the following formats:
A map provided in a standard image or PDF file format must be in a scale that readily permits precise identification of the boundaries of the service area and depicts the proposed location in relation to its surrounding areas. This map must provide a level of detail comparable to that contained in the paper map previously required by the Commission (1:50,000 NTS topographical map). A map provided in a GIS-compatible file format must be created using a map datum of NAD83. The Commission will only accept the following GIS-compatible file extensions:
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| b) |
For radiocommunication distribution undertakings, a contour/service area map provided as part of the Industry Canada technical submission is to be provided electronically in one of the following formats:
A map provided in a GIS-compatible file format must be created using a map datum of NAD83. The Commission will only accept the following GIS-compatible file extensions:
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5. Employment equityInformation relating to employment equity is available
in Public Notices CRTC 1992-59 and 1997-34. |
| 5.1 | If the proposed undertaking is approved, would the licensee be subject to the 1996 Employment Equity Act (applicable to federally-regulated employers with 100 or more employees)? |
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| YES ( ) |
NO ( ) | ||
| If YES, do not complete the remainder of this section. If NO, proceed to question 5.2. |
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| 5.2 | If the proposed undertaking is approved, would the licence be held by a licensee that already holds one or more broadcasting licence(s)? |
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| YES ( ) |
NO ( ) | ||
| If YES, proceed to question 5.3. If NO, proceed to question 5.7. |
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| 5.3 | Outline examples of any measures (including hiring and training, apprenticeship programs, work arrangements, etc.) that you have or will put in place for the designated groups (women, Aboriginal peoples, persons with disabilities and visible minorities). |
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| Questions 5.4 to 5.6 - applicable if between 25 and 99 employees only: |
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| 5.4 | How do you or will you communicate details of your employment equity policies to managers and staff? |
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| 5.5 | Have you assigned or will you assign a senior level person to be responsible for tracking progress and monitoring results? |
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| YES ( ) |
NO ( ) | ||
| If YES, what authority does or will that person have to ensure goals are achieved? |
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| 5.6 | What financial resources have you or will you put in place to promote employment equity in the workplace (for example, funds for daycare, access for persons with disabilities, etc.)? |
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| Questions 5.7 and 5.8 - applicable if response to questions 5.2 is "no" |
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| 5.7 | To what extent will the proposed undertaking address the equitable representation of the four designated groups (women, Aboriginal peoples, persons with disabilities and visible minorities)? |
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| 5.8 | Does the proposed undertaking have an employment equity (EE) plan? |
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| YES ( ) |
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| If YES, please describe the principal measures proposed to recruit and assist members of the four designated groups (for example, work arrangements, apprenticeship or training programs, career counselling, etc.). |
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| NO ( ) |
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| If NO, please provide a statement indicative of your commitment to develop and implement an effective EE plan. |
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Sections 30 to 34 of the Canadian Radio-television and Telecommunications Commission Rules of Practice and Procedure set out a process by which parties to Commission proceedings may file information on the record of a public proceeding in confidence.
A party filing information can “designate” it as confidential at the time it is filed with the Commission (section 31) if it falls into one of the following categories:
At the time that the party files the information it designates as confidential, it must provide an abridged version of the document along with an explanation of how the information falls into a category of information listed in section 31. The party must provide a detailed rationale to explain why the disclosure of the information is not in the public interest (section 32(1)).
The confidential version of the document must be filed separately and must be marked “CONFIDENTIAL” on each page. If the document is filed electronically, each file containing confidential information must include “CONFIDENTIAL” in the file name.
The abridged version of the document and the reasons for the designation of information as confidential will be placed on the public record of the proceeding.
Please consult the Implementation of new Rules of Practice and Procedure, Broadcasting and Telecom Regulatory Policy CRTC 2010-958, 23 December 2010, and the Procedures for filing confidential information and requesting its disclosure in Commission proceedings, Broadcasting and Telecom Information Bulletin CRTC 2010-961, 23 December 2010, for complete process for filing confidential information.
Are you requesting for some information to be designated as confidential?
Yes ( ) No ( )
If yes, you must provide a detailed rationale to explain why the disclosure of the information is not in the public interest :
BOOK OF SUPPORTING DOCUMENTS |
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APPENDIX NUMBER AND NAME |
APPENDED |
E-FILED |
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SECTION 1: GENERAL INFORMATION |
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1A |
Supplementary Brief | ||
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SECTION 2: OWNERSHIP |
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2A |
Constituting Documents (or drafts) | ||
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2B |
Statement on Control of Applicant | ||
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2C |
Delegation of Responsibility by Contract | ||
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SECTION 4: SERVICE INFORMATION |
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4A |
Map(s) - Proposed Service Area | ||
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***End of Document*** |