A-353 Form 2 Power of Attorney

A-353 Form 2 Power of Attorney

Form 2 Power of Attorney

being an incorporated company, incorporated under the laws of:

applying for a licence from the Superintendent of Insurance of Nunavut to effect contracts of:

and other classes of insurance within Nunavut, under the Insurance Act, declare, constitutes and appoints:

of

in Nunavut, its lawful attorney and Chief Agent and the place of Chief Agency in and for the Territory of Nunavut. The Chief Agent named in this power of attorney is expressly authorized to receive and accept the service of notice or process in all actions and proceedings against the Company in Nunavut for any liability incurred by the Company in those actions and proceedings and to receive from the Superintendent all notices that the law requires to be given or that is thought advisable to give. The Company declares that services of notice of process for or in respect of such liability on the Chief Agent named in this power of attorney is legal and is binding on the Company.

Given under the corporate seal of:

and signed by its duly authorized offices on:

Signed in the presence of:

Sign above
Sign above

executed the Power of Attorney

and that they hold the offices of respectively in the Company referred to in the Power of Attorney.

(Place)
Sign above

The Government of Nunavut supports use of the territory’s official languages. If you would like to correspond with Nunavut’s Office of the Superintendent of Insurance in an official language other than English, please inform us.
ᐅᖃᐅᔨᔪᓐᓇᖅᐳᑎᑦ ᐅᕙᑦᑎᓂᑦ ᐋᔨᖃᑎᖃᕈᒪᒍᕕᑦ ᐃᓕᓴᕆᔭᐅᓯᒪᔪᒃᑯᑦ ᐅᖃᐅᓯᒃᑯᑦ ᐊᓯᐊᒍᖔᖅ ᖃᓪᓗᓇᐅᔭᖅᑑᑉ.

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