Legal Name of Firm:

Phone:

Trade Name:

Address:

City:

Province:

Postal Code:

Type of Business:

Is Business Corporated: Yes No

If Yes Date Incorporated:

NAMES, HOME ADDRESSES OF PRINCIPAL(S), SOLE PROPRIETORSHIP. OR PARTNERSHIP

Name:

Address:

Telephone:

Do you own?:

If Lease, Name of Landord:

Seating Capacity of Restaurant:

Length of Time In Business:

Bank Information:

Bank:

Account:

Account Name:

Branch:

Phone: