Current Page 1 Page 2 Preview Personal information on this form is collected under Section 1.1 of the Collection Agencies Act, Regulations as it relates directly to and is necessary for an application to collect debt. If you have any questions about this collection of personal information you may contact the Consumer, Corporate and Financial Services, Prince Edward Island, 902-368-4550. Identification Business/Organization Name Contact First Name Contact Last Name Address 1 Address 2 City, Town, or Community Province Postal Code For example C1B 0X1 or 12345 Country Telephone 1 For example 902-555-5555 Telephone 2 For example 902-555-5555 Fax Number For example 902-555-5555 Email Address PEI Collection Agency License Number Enter the four or five digit PEI Collection Agency License Number