Change of Address/Method
of Delivery Application
Individual or Business Name (Required)
Send to Information Services Corporation at: e-Business, 1301 1st Avenue, Regina, SK S4R 8H2
-OR- Email: e-B
SC@isc.ca -OR-
Fax: (306) 798-1399
ISC-EBS-CHA-0001-2015-09-02
Address
City
Province/State
Country (if outside of Canada)
Fax Number (include Area Code)
Postal/Zip Code
Phone Number (include Area Code)
SECTION D - SUBMITTING PARTY INFORMATION (Required)
Contact Name
Phone Number (include Area Code)
Fax Number (include Area Code)
Email Address
SECTION E - DATE & SIGNATURE
Date:
Client Signature:
Print Name:
(For Client Number changes only)
SECTION B - CHANGE METHOD OF DELIVERY
Date Received
Date Processed
Initials
FOR OFFICE USE ONLY
SECTION A - CLIENT INFORMATION
Client Number (Required)
SECTION C - CHANGE OF ADDRESS
Name of Recipient (if different than outlined in Section A)
Canada Post
Fax (include Fax Number within Section C)
Email:
(include a valid email address)
(When signing on behalf of an Individual or Business Name, indicate legal authority):
