Current Page 1 Page 2 Preview Personal information on this form is collected under section 32(10)(g)(1) of Prince Edward Island’s Freedom of Information and Protection of privacy Act and will be used for the purpose of assessing your application of credit. If you have any questions about this collection of personal information, you may contact a Department Manager. Identification I, the applicant, understand that I am NOT eligible for this program if my property is connected to centralized/municipal water and sewer. Provide the mailing address in the fields below. 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 Business Information Type of Organization - Select -CooperativeFederally IncorporatedIncorporatedNon-ProfitSole ProprietorshipTo Be Incorporated Owners/Partners/Shareholders Click the Add button to enter additional owners, partners, or shareholders. Owners/Partners/Shareholders First Name Last Name % of Shares Item weight Add more items more items