Application for a classification certificate form

3. OPERATOR

* Private informations. The operator must own or rent the establishment (see s. 10.1(2) and s. 1 of the Regulation respecting tourist accommodation establishments).

3.1 Type (choose one)*

Owner
Tenant

3.2 The owner or tenant is an*

Physical person
Corporation (company)

3.2a Corporation's Name*

The operator must own or rent the establishment (see s. 10.1(2) and s. 1 of the Regulation respecting tourist accommodation establishments).

3.2b NEQ Contain 10 digits start with 11, 22, 33 or 88*

Quebec enterprise number: http://www.registreentreprises.gouv.qc.ca

3.3 Number of tenants*

Indicate the number of tenants of the establishment.

3.3a Gender and full name of the tenant

Tenant 1 - Gender*

Tenant 1 - First Name and Last Name*

Tenant 2 - Gender*

Tenant 2 - First Name and Last Name*

Tenant 3 - Gender*

Tenant 3 - First Name and Last Name*

Tenant 4 - Gender*

Tenant 4 - First Name and Last Name*

Tenant 5 - Gender*

Tenant 5 - First Name and Last Name*

3.3 Number of owners*

Indicate the number of owners of the establishment.

3.3a Gender and full name of owners

Owner 1 - Gender*

Owner 1 - First Name and Last Name*

Owner 2 - Gender*

Owner 2 - First Name and Last Name*

Owner 3 - Gender*

Owner 3 - First Name and Last Name*

Owner 4 - Gender*

Owner 4 - First Name and Last Name*

Owner 5 - Gender*

Owner 5 - First Name and Last Name*

Address*

3.4 Address 3.4.1 Appartment, office or local 3.5 City 3.6 State / Province 3.7 Postal Code 3.8 Country

Address of the person (or company) operating the establishment.

3.9 Telephone (main)*

The operator's telephone numbers will not be published.

3.10 Telephone (other)

Other number for reaching the operator (cell, pager, office, etc.).

3.11 Fax

3.12 Operator's e-mail

3.13 Do you have a contract of mandate issued by the operator, authorizing you to submit this application for a classification certificate on his or her behalf?*

Yes
No

Complete if you have been mandated by contract by the operator to complete this classification certificate application form.

3.14 AUTHORIZED AGENT INFORMATIONS

Private informations

3.15 Authorized agent informations is a*

Physical person
Corporation (company)

3.15a Name of mandatary*

Name of mandatary, i.e. the firm mandated by the operator to manage its CITQ file.

3.15b Coporation's name*

Name of mandatary, i.e. the firm mandated by the operator to manage its CITQ file.

3.15c NEQ Contain 10 digits start with 11, 22, 33 or 88*

Quebec enterprise number: http://www.registreentreprises.gouv.qc.ca

Address*

3.16 Address 3.16.1 Appartment, office or local 3.17 City 3.18 State / Province 3.19 Postal Code 3.20 Country

3.21 Telephone (main)*

3.22 Telephone (other)

3.23 Fax

3.24 E-mail agent

REPRESENTATIVE

Note that the CITQ allows only one physical person access to the file, by delegation of authority.

3.25 Name of representative*

Gender First name Last name

3.26 E-mail of representative

3.27 Telephone of representative

3.28 Language of correspondence (check one)*

English
French

3.29 Mailing address (check one)*

Same as mandatary address
Same as operator address (see 3.4)
Same as the rental establishment address
Other adresse

3.29 Mailing address (check one)*

Same as operator address (see 3.4)
Same as the rental establishment address
Other adresse

Other adresse*

3.30 Address 3.31 Municipality 3.32 Province 3.33 Postal Code 3.34 Country

1. ESTABLISHMENT

2. CLASS / ACCOMODATION UNITS

3. OPERATOR

3.14 AUTHORIZED AGENT INFORMATIONS

REPRESENTATIVE