Apply to Renew your L.P. Gas Personnel License

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Personal information on this form is collected under section 31 (c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, c. F-15.01 as it relates directly to and is necessary for the administration of the Propane, Natural and Manufactured Gas Program. If you have any questions about this collection of personal information, you may contact the Chief Officer, 31 Gordon Drive, Charlottetown, PE, Canada P.O. Box 2000 C1A 7N8, Tel: 902-368-5567.

Identification

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address

Employer Information

Business Name

Business Address

Business Telephone

For example 902-555-5555

Business E-mail