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PDC Form (#8)

Business Name

Date (day/month)

Signing Authority Name

Signing Authority Email

Corporation Name

Signing Authority Title

Signing Phone Number

Business Mailing Address *

Apt./Suite

Apt./Suite

City

Province

Postal Code

Signing Authority Mailing Address *

Same as Business Mailing Address

Same as Business Mailing Address

Apt./Suite

Apt./Suite

City

Province

Postal Code

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