Representation of Accuracy, Compliance, and Permission to Inquire
I, the undersigned person, on behalf of Applicant, represent to PetSmart Charities of Canada, Inc.
(“PCCI”) that: (1) I am authorized to submit this application and make all representations
provided in and with this application; and (2) to the best of my knowledge, the information
contained in this application is true and accurate. On behalf of the Applicant and its officers,
directors, employees and volunteers, I grant permission to PCCI, its staff and any other
designated representatives to make inquiries with, and request documentation from, third parties
about Applicant and the contents of this application, to assist in the evaluation of this grant
request.
In addition, as of the date of signing, the Applicant represents to PCCI that: (1) the Applicant is
either (a) a registered charity with the Canada Customs and Revenue Agency and that the
Organisation is not a private foundation, or (b) a city/county/provincial/tribal government entity; (2)
the Applicant validly holds and maintains all licenses, permits, and registrations, and has satisfied
all similar requirements, necessary for its lawful operation; and (3) the Applicant is in compliance
with all applicable local, provincial, tribal and federal laws, regulations and other requirements to
which the Applicant is subject. The Applicant agrees to notify PCCI promptly in writing of any
change in the information represented herein.
Signed by Authorized Representative of the Applicant:
_______________________________
Signature
_______________________________
Print name
_______________________________
Title
_______________________________
Date
Targeted s/n application-Canada 2010
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