Form Yg(5390q) F2 - Renewal Agency Application Page 2
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1
2AFFIDAVIT • AFFIDAVIT
Je/nous _________________________________________
I/We ____________________________________________
de la société/société en nom collectif __________________
of the Firm/Partnership _____________________________
_______________________________________________
________________________________________________
carrying on the business at
__________________________
exerçant ses activités à _____________________________
Make oath and say as follows:
Déclare/déclarons ce qui suit :
Je/nous soussigné(s), administrateur(s)/associé(s) de l’entreprise
I/We being directors/partners in the aforementioned
susmentionnée, atteste/attestons que les renseignements donnés
business swear that all information and details provided
by me/us in the application for a ______________________
dans la demande de licence d’agence de __________________
agency licence are true and correct to the best of my/our
sont exacts et que, pour autant que à ma/notre connaissance,
knowledge and belief and that I/we are not aware of any
rien ne s’oppose à ce que la licence demandée soit délivrée en
impediment which would affect the granting of the said
vertu de la Loi sur les détectives privés et les gardiens de sécurité.
licence under the provisions of the Private Investigators and
Security Guards Act.
Sworn before me at
in
Déclaré devant moi à
________________________________________________
au _________________________________
this
day of
20
ce
___________________________________
jour de ________________________________________ 20
__________________________________
__________________________________
________________________________
Notary Public in and for Yukon
Signature • Signature
Signature • Signature
Notaire public du Yukon
CAUTION: Any person who knowingly furnishes false information in an application under the Private Investigators and Secu-
rity Guards Act commits an offence and may result in the refusal of a Licence.MISE EN GARDE : Toute personne qui fournit
sciemment de faux renseignements dans une demande présentée sous le régime de la Loi sur les détectives privés et les
gardiens de sécurité commet uneinfraction pouvant entraîner le refus de la licence.
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