51 105f3a 2025

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The document is Form 51-105F3A, a Personal Information Form required by individuals associated with issuers quoted in U.S. over-the-counter markets. It mandates the collection and disclosure of personal information to securities regulatory authorities, ensuring all questions are answered accurately. The form includes sections on personal identification, citizenship, employment history, legal issues, and consent for information use. It emphasizes the importance of truthful responses and outlines potential legal consequences for false statements.

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