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Industry
Convenience Store
Gas Station Store
Wireless Mobile
Products
Prepaid Cards and Gift Cards
Mobile Dealer
Gaming Vouchers
Wireless
Meet the Team
Blog
Contact
Sign Up Now
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Ownership Change
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Store Information
-
Step
1
of 3
Ownership Change Date
*
Please provide ticket number or the previous retailer ID/account number.
*
Contact for Store
Store Contact First Name
*
First Name
Store Contact Last Name
*
Last Name
Type of Business
*
Corporation
Sole Proprietorship
Partnership
Store Name (Doing business as)
*
Company Legal Name
*
(Exactly as it appears on your business license)
Store Phone Number
*
Store Email Address
*
Email
Confirm Email
Store Address
Store Street Address
*
Address Line (Please include suite or unit number if required)
Store City
*
City
Store Province
*
AB
BC
MB
NB
NL
NS
ON
PE
QC
SK
YT
NT
NU
Province
Store Postal Code
*
Postal Code
HST/GST Number
*
Do you have a PST/QST Number? (For applicants in BC, SK, MB & QC)
*
Yes
No
Please provide your PST/QST Number
*
Next
New Owner's Name
Owner First Name
*
First Name
Owner Last Name
*
Last Name
Owner's Mobile Phone Number
*
Owner's Email
*
Email
Confirm Email
(Please note that this email will be used to sign the retailer agreement through Adobe Sign)
Owner's Home Address
Owner Street Address
*
Address Line
Owner City
*
City
Owner Province
*
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Province
Owner Postal Code
*
Postal Code
Owner's Date of Birth
*
Next
Store Billing Address
*
Same as Store
Same as Owners Home Address
Different from Store & Home Address
Please notes any
Billing Address
Billing Street Address
*
Address Line
Billing City
*
City
Billing Province
*
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Province
Billing Postal Code
*
Postal Code
By checking this box, I agree to adopt the same services, fee structure (if applicable), and terms as those associated with the previous account under the former owner.
*
Yes, I agree to adopt the same services, fee structure (if applicable), and terms as those associated with the previous account under the former owner.
Please provide any additional notes or information you'd like us to include as we set up your account.
Single Line Text
Submit
