Policy and Licensing Procedures for the Auction of Spectrum Licences in the 2300 MHz and 3500 MHz Bands – Appendix 8

Appendix 8 – Declaration of Ownership and Control for Provisional Winners of the 2300 MHz and 3500 MHz Licences

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Appendix 8 – Declaration of Ownership and Control for Provisional Winners of the 2300 MHz and 3500 MHz Licences
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Note: If the provisional licence winner is not a corporation, then documents dealing with the same subject matters must be submitted.

I, the undersigned, do hereby make the following statements that I certify to be true and complete in every respect.

I certify, on behalf of
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(Name of Provisional Licence Winner)
that:
I have read and I understand the contents of the Canadian carrier eligibility criteria as set out in section 10 of the Radiocommunication Regulations and
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(Name of Provisional Licence Winner)
complies with the said Canadian carrier ownership and control requirements.

The following required supporting documents are attached:

I. General

1.1 A narrative explaining the company's Canadian ownership and control structure.

II. Incorporation Documents

The incorporation documents, including articles of incorporation, bylaws, addendums,

2.1 The incorporation documents, including articles of incorporation, bylaws, addendums, and appendices.
2.2 All agreements between or among operating company, holding company and any other affiliated companies related to the governance or management of these companies.

III. Shareholdings

3.1 Certified copies of the current Register of Shareholders, for all classes and series of shares, stating the citizenship and ordinary residence of each shareholder, for the company and holding company(ies).
3.2 The details of the rights, privileges, restrictions and conditions of each class of shares for the company and holding company(ies).
3.3 For each shareholder who is an individual and identified as "Canadian" (as defined in the Canadian Telecommunications Common Carrier Ownership and Control Regulations), an affidavit or statutory declaration regarding citizenship, residency and ordinary residence. However, where shares of the corporation are widely held, and where the Register includes the address of each registered shareholder, a certified copy of the register will be sufficient.
3.4 Where shares are held in trust, the name and address of the trustee are required, and where the trustee is an individual, the citizenship of the trustee.
3.5 Any other document identifying the details of the beneficial ownership by Canadians, and by non-Canadians, of each class of shares for the company and any related holding company.
3.6 Copies of all shareholders or partnership agreements for the company and any related holding company.

IV. Directors

4.1 Certified copies of the current Register of Directors for the company and any related holding company, indicating citizenship and residence.
4.2 If there is a relationship between a director and a non-Canadian shareholder, information regarding the nature of that relationship. (e.g. Employee, officer, director, shareholder, significant contract, or spouse of employee, officer, director, shareholder.) 
4.3 The details of any agreements or arrangements related to the nomination, designation or election of directors of the company and any related holding company.
4.4 An affidavit or statutory declaration regarding Canadian citizenship or residency, and ordinary residence, of any individual director identified as "Canadian" (as defined in the Canadian Telecommunications Common Carrier Ownership and Control Regulations).

V. Officers

5.1 The name and citizenship of each officer, and office held of each officer of the company and any related holding company, and details of any relationship between the officers and non-Canadian shareholders.
5.2 The details of any agreements or arrangements related to the appointment of officers of the company and any related holding company.

VI. Financing

6.1 The complete details of the financial structure of the company and any related holding company, including the source of debt and equity financing. Please provide details as to the share structure, source of financing (banks, shareholders, passive investors, etc.), and provide copies of any agreement related to current or future Canadian or non-Canadian equity (voting and non-voting).

VII. Agreements

7.1 Copies of any agreements or covenants between the company and any non-Canadian partner or affiliate, including agreements or arrangements for the provision of management services, acquisition of intellectual property, or instruments granting current or future rights in the company's radiocommunication assets.
7.2 The details of any other agreement or arrangement which could affect whether the company or any related holding company are or are not controlled in fact by Canadians.

Important Notice:

Industry Canada reserves the right to review all ownership and control information submitted with this form and to request further information.

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(Printed Name and Signature)

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(Position Title)

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(Date)


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