Form YG5135 "Pawnbroker and Second-Hand Dealer Licence and Renewal Application" - Yukon, Canada

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Download Form YG5135 "Pawnbroker and Second-Hand Dealer Licence and Renewal Application" - Yukon, Canada

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PAWNBROKER AND SECOND-HAND DEALER
LICENCE AND RENEWAL APPLICATION
You must visit the pawnbrokers and second-hand dealers licence application web pages to complete your application
package. Full instructions, forms and guidance documents are found on the following web pages:
Apply for new pawnbroker and second-hand dealer licence
Renew pawnbroker and second-hand dealer licence
For convenience, a brief checklist of required supporting documentation is provided below.
Supporting documentation checklist (More information is found on the application website.)
Copies of 2 pieces of government-issued ID. (Required for new applicants or if the individual applying on behalf of
the business has changed.)
Proof that your business is either:
• Registered and in good standing with Government of Yukon Corporate Affairs; or
• Holds a municipal business licence and is in good standing.
Payment information form. ($10 per class.)
YG(5135EQ)F2 Rev.01/2018
Page 1 of 2
PAWNBROKER AND SECOND-HAND DEALER
LICENCE AND RENEWAL APPLICATION
You must visit the pawnbrokers and second-hand dealers licence application web pages to complete your application
package. Full instructions, forms and guidance documents are found on the following web pages:
Apply for new pawnbroker and second-hand dealer licence
Renew pawnbroker and second-hand dealer licence
For convenience, a brief checklist of required supporting documentation is provided below.
Supporting documentation checklist (More information is found on the application website.)
Copies of 2 pieces of government-issued ID. (Required for new applicants or if the individual applying on behalf of
the business has changed.)
Proof that your business is either:
• Registered and in good standing with Government of Yukon Corporate Affairs; or
• Holds a municipal business licence and is in good standing.
Payment information form. ($10 per class.)
YG(5135EQ)F2 Rev.01/2018
Page 1 of 2
PAWNBROKER AND SECOND-HAND DEALER
LICENCE AND RENEWAL APPLICATION
Complete all sections of this application form. Do not leave a section
Check all that apply:
blank. If a section is not relevant, mark the section as “not applicable.”
Pawnbroker
Second-hand dealer
Applicant information
Legal last name
Legal first name(s)
Legal middle name(s)
Other names by which you may be known
Position in the company/business
Email
Phone
Mailing address
City
Prov./terr.
Postal code
Country
Physical address
City
Prov./terr.
Postal code
Country
(if different from mailing address)
Company/business information
Primary business name
Business email
Business phone
Business mailing address
City
Prov./terr.
Postal code
Country
Business physical address
City
Prov./terr.
Postal code
Country
(if different from mailing address)
Additional business locations
Provide a list of all the businesses subject to the Pawnbrokers and Second Hand Dealers Act.
Business name
Physical address
Pawnbroker, second-hand dealer, or both
Personal certification
Yes, I hereby certify, as the individual with the authority to apply on behalf of the business listed, that all statements are
true and complete in every respect. I understand that falsification of information on this application may result in the
cancellation of the application for licensure or cancellation of an issued licence.
Y Y Y Y
/
M M
/
D D
_______________________________________________________________
______________________________
Signature of applicant
Date
Personal information is collected, used, and disclosed under the authority of Section 29(a) and (c) of the Access to Information and Protection of Privacy Act and under the
Act associated to the profession related to the licence being requested. It will be used for the purposes of these acts and their regulations and to determine eligibility for
licensure/registration. It will also be used to maintain a public register and for research and statistical purposes related to human resource planning. The latter is shared in a
non-identifiable form only. For further information about the collection of this information, contact Professional Licensing and Regulatory Affairs (PLRA), Community Services,
Government of Yukon, by mail at P.O. Box 2703, Whitehorse, YT, Y1A 2C6, by phone at 867-667-5111, or by email at pbsh.plra@gov.yk.ca.
YG(5135EQ)F2 Rev.01/2019
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