Form 41 - Certificate Of Permission To Act Renewal Application & Declaration

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Law Society of Yukon
#202 – 302 Steele Street
Whitehorse, Yukon Y1A 2C5
Phone: 867-668-4231
Fax: 867-667-7556
E-mail:
Website:
FORM 41
Certificate of Permission to Act
Renewal Application & Declaration
1.
Name
Last Name
First Name
Middle Name(s)
2.
Business Address
Name of Firm/Employer
Street
City
Province/Territory
Country
Postal Code
Telephone
Fax
E-mail Address
(
)
(
)
3.
Date Original Certificate was Issued
Year:
Month:
Day:
Style of Cause or Matter:
Form 41
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