6 - Declaration I hereby certify that I have the relevant knowledge of the cooperative and that I am authorized to sign this form. Signature Print name Note: Every person who knowingly contravenes this Act or who does not fulfil a duty imposed under this Act is guilty of an offence punishable on summary conviction (Section 349 of the Canada Cooperatives Act). IC 2655E (2016-01) 1 - Name of the cooperative Canada Cooperatives Act Form 3022 ANNUAL RETURN 3 - Year of filing 4 - Date of last annual meeting Yes No 5 - Does the cooperative distribute its securities to the public? - 2 - Cooperative number
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6 - DeclarationI hereby certify that I have the relevant knowledge of the cooperative and that I am authorized to sign this form.
SignaturePrint name
Note: Every person who knowingly contravenes this Act or who does not fulfil a duty imposed under this Act is guilty of an offence punishable on summary conviction (Section 349 of the Canada Cooperatives Act).
IC 2655E (2016-01)
1 - Name of the cooperative
Canada Cooperatives Act Form 3022
ANNUAL RETURN
3 - Year of filing
4 - Date of last annual meeting
Yes No
5 - Does the cooperative distribute its securities to the public?
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2 - Cooperative number
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Symbole du Canada
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6 - Declaration
Declaration
I hereby certify that I have the relevant knowledge of the cooperative and that I am authorized to sign this form.
I hereby certify that I have the relevant knowledge of the cooperative and that I am authorized to sign this form.
Signature
Signature de l'administrateur.
Note: Every person who knowingly contravenes this Act or who does not fulfil a duty imposed under this Act is guilty of an offence punishable on summary conviction (Section 349 of the Canada Cooperatives Act).
IC 2655E (2016-01)
The identification number of form 3022 is IC 2655E - July 2013.
Canada Cooperatives Act
Form 3022
ANNUAL RETURN
Canada Cooperatives Act (Coop Act)Form 3022 ANNUAL RETURN(Section 374)
5 - Does the cooperative distribute its securities to the public?
Does the cooperative distribute its securities to the public?
2 - Cooperative number
Cooperative number
E
Guy Chaussé and Gary Kenny
August 2008
Industry Canada
FORM 3022 - ANNUAL RETURN
Nancy Mathieu
IC2655E - ANNUAL RETURN
November 2015
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