Register

Registration Form - Extended Producer Responsibility (EPR) Programs

Batteries 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 Code/Zip:

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

(If multiple locations in New Brunswick, please register each one separately.)

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 Code:

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The contact information of the 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 Code/Zip:

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Alternate Contact

Name:

Email:

Telephone Number:

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Mailing Address:

City/Town:

Province/State:

Country:

Postal Code/Zip:

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The information for any Producer Responsibility Organization (PRO) acting on behalf of the applicant:

(If the applicant has not yet designated a PRO to perform the obligations imposed by the Designated Materials Regulation on their behalf, the applicant is responsible for performing all obligations under the Regulation and should provide applicant information in this section. Once the applicant has designated a PRO, the applicant must notify Recycle NB of this change.)

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 Code/Zip:

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I hereby acknowledge that this applicant understands the requirement to notify Recycle NB within ten days of any change to the information provided on this form as per Section 17 of the Designated Materials Regulation.

Signature

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