Get Fillable Directive 067

This guide provides a step-by-step approach to completing the Fillable Directive 067 form. By following these instructions, users will efficiently fill out the necessary information online while ensuring accuracy and compliance.

Follow the steps to complete the Fillable Directive 067 form.

1. Click the ‘Get Form’ button to access the Fillable Directive 067 form and open it in your online editor.
2. Begin by entering the information for the potential licensee. This includes the applicant's name, abbreviated corporate name, address, telephone, fax number, 24-hour emergency response number, email, Alberta corporate access number, and the contact person for this schedule.
3. In section B, indicate whether you are applying for a new business associate code, amending an existing license eligibility type, or updating a corporate profile. If you have an existing BA code, please provide it.
4. Complete section C by checking the appropriate boxes that indicate the licensing purpose of your application. Attach any required proofs of insurance or other documents listed.
5. If applicable, fill out section D for the corporate profile. List shareholders as instructed, and provide the names of directors and senior officers of the corporation.
6. In section E, one of the corporate officers must declare the accuracy of the information provided. This includes a signature and printed name, as well as their title and location.
7. Finally, ensure you review the completed form for accuracy and completeness. You can then save your changes, download a copy for your records, print the form, or share it as needed.

Complete your Fillable Directive 067 form online today and ensure your submission is accurate and compliant.