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[null,null,null,null,null,null,null,null,null,null,null,null,null,"Version : 2016-05-01"]
["Abridged Application for an Initial Qualification Certificate"]
["Cautionary notice\n\nThis form is intended for corporations resulting from a merger, where either of the replaced corporations held an initial qualification certificate for a payroll tax credit."]
[]
["Act respecting the sectoral parameters of certain fiscal measures"]
["For more information on the eligibility criteria for payroll tax credits, please consult Chapters XI and VII of Schedule A of the Act respecting the sectoral parameters of certain fiscal measures or the detailed fact sheet available on our website"]
[]
["Submitting the application for a certificate"]
["For Investissement Québec to begin reviewing the corporation's Application for an Initial Qualification Certificate, your file must be complete. Fill in all the sections of the form and attach all the documents requested in section 4.\n\nTo speed up the processing of your application, you must also send us your form by email at the address indicated at the end of this form."]
[]
["Fee"]
["Investissement Québec charges a fee for reviewing applications to determine eligibility for the tax measures it administers. If you wish to obtain more information about the fee, please visit the following section of our website: http://www.investquebec.com"]
[]
["Agreement to exchange information"]
["On October 7, 2009, Investissement Québec and Revenu Québec signed an agreement entitled \"Entente portant sur l'échange de renseignements nécessaires à l'administration de mesures fiscales ou à l’application d’une loi fiscale\" [agreement on the exchange of information required for the administration of fiscal measures or the enforcement of a tax statute]. Under that agreement, the two organizations can share information required for the exercise of their respective mandates without being obliged to ask for the consent of the individual in question. We disclose information to Revenu Québec solely within the framework of this agreement. The Commission d'accès à l'information du Québec has approved this agreement, after analyzing the nature of the information provided and the reasons for which it is disclosed, and ensuring that appropriate security measures and measures to ensure confidentiality were put in place."]
[]
["1. REFUNDABLE TAX CREDIT(S) CONCERNED"]
[]
[null,"Processing Activities in Resource Regions"]
[null," "]
[null,"Gaspésie and Certain Maritime Regions of Québec"]
[]
[null,"Gaspésie and Certain Maritime Regions of Québec (fields of marine biotechnology, mariculture, marine products"]
[null,"processing and recreational tourism)"]
[]
[null,"Aluminum Valley"]
[]
["2. IDENTIFICATION OF THE COMPANY"]
["Company name"]
[]
["NEQ  (Québec enterprise number)",null,null,null,null,null,null,null,null,null,"IQ business number",null,null,null,null,null,null,null,null,null,"IQ file number*",null,null,null,null,null,null,null,null,"Date of incorporation"]
[]
[]
["*This is the file number for the Tax Credit for the payroll tax credit. It is not required for a first application. In the case of a second application, you can find this number on the correspondence you received from Investissement Québec."]
[]
["Company's website URL"]
[]
[]
["Addresses of all of the establishments in Québec (if more than one establishment, please append the complete list)"]
[]
[]
[]
[]
["Mailing address"]
[]
[]
[]
[]
["Authorized corporation representative"]
[]
[]
["Representative's title",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Telephone",null,null,null,null,null,"Ext"]
[]
["Representative's email address",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fax"]
[]
[]
["3. CONFIRMATION OF ACTIVITIES"]
[]
["The corporation must inform Investissement Québec of the new activities that it will carry on following the merger."]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Yes",null,null,"No"]
[" - ","The corporation will carry on the same activities as the replaced corporation that held an"]
[null,"eligibility certificate for one or more of the credits mentioned in section 1."]
[]
["Please specify the new activities and the addresses of the new establishments, if applicable."]
[]
[]
["4. DOCUMENTS TO ATTACH TO THIS APPLICATION"]
["—  Copy of the company's non-consolidated most recent financial statements (compulsory);"]
["—  Power of attorney, duly signed, designating a mandatary to represent the corporation to Investissement Québec, if need be."]
[]
["5. DECLARATION OF AUTHORIZED COMPANY REPRESENTATIVE"]
["I, the undersigned, duly authorized representative of the company, declare that the information provided in this application and the related documents is complete and accurate in every respect and undertake to provide to the representative of Investissement Québec any information necessary to process this application for an initial eligibility certificate."]
["Furthermore, unless otherwise expressly stated, I authorize the Tax Measures Department to share with the other departments of Investissement Québec any information obtained in the course of this application that could prove necessary for the analysis of any application for financing, investment or any other service provided by Investissement Québec."]
[null," I authorize the sharing of information"]
[]
[null," I do not authorize the sharing of information"]
["Finally, I certify that the company has not modified the contents of this application."]
[]
["Signature of the company's authorized representative",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Date"]
[]
["Return the completed form to one of the following address:"]
["Applications regarding establishments in the administrative regions of Gaspésie–Îles-de-la-Madeleine, Nord-du-Québec and Saguenay–Lac-Saint-Jean:\n\nInvestissement Québec\nDirection, Mesures fiscales (Québec)\nÉdifice Iberville 1\n1195, avenue Lavigerie, bureau 060\nQuébec (Québec)  G1V 4N3\nmfquebec@invest-quebec.com\n\nTelephone: 418 643-5172\nToll free: 1 866 870-0437"]
["Applications regarding establishments in the administrative regions of Abitibi-Témiscamingue or Mauricie or in the regional county municipalities (RCMs) of Antoine-Labelle, La-Vallée-de-la-Gatineau and Pontiac:\n\nInvestissement Québec\nDirection, Mesures fiscales (Montréal)\n1001, boulevard Robert-Bourassa, bureau 1000\nMontréal (Québec) H3B 4L4\nmfmontreal@invest-quebec.com \n\nTelephone: 514 873-4375\nToll free: 1 866 870-0437"]