Register

Brand Owner Registration Form

Oil, Oil Filters and Glycol Program

Applicant Information

Name of Applicant (Legal Business Name):

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The location of the head office of the applicant:

Physical Location:

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Mailing Address:

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Province/State:

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Country:

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Postal/Zip Code:

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The location of the main place of business in New Brunswick:

Same address as above

We do not have a location in New Brunswick

Physical Location:

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Mailing Address:

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Postal/Zip Code:

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If a Corporation, provide the following information relating to all the officers of the corporation:

Name:

Title:

Title: - Other

Mailing Address:

Province/State:

Country:

Postal/Zip Code:

Add an Officer

Name, Address and Telephone Number of Person to whom any correspondence or inquiries should be directed:

Name:

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Email:

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Telephone Number:

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Mailing Address:

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City/Town:

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Province/State:

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Country:

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Postal/Zip Code:

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Name, Company Name, Address and Telephone of any AGENT acting on behalf of the Applicant:

A brand owner may submit a products stewardship plan as outlined in the Designated Materials Regulation under the Clean Environment Act or assign an agent to submit a plan on its behalf. Refer to the Designated Materials Regulation for details.

Name:

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Company Name:

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Email:

Please enter a valid email address

Telephone Number:

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Mailing Address:

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Province/State:

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Country:

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Postal/Zip Code:

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Signature

Please type your full name, which acts as your electronic signature