Request to Modify Registration Information or to Replace the Attestation d'Inscription Issued to a Band Council, Tribal Council or Band-Empowered Entity
CA-1002.M-V

This form is intended for band councils, tribal councils or band-empowered entities that are registered for the Program for Administering the Fuel Tax Exemption for Indians. Complete this form if you wish to

modify information on a registration application that has already been filed;
obtain additional Attestations d'inscription (registration cards);
cancel one or more Attestations d'inscription; or
have one or more Attestations d'inscription replaced, in the event of a loss or theft.

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This form can be signed electronically.

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