Application for a Financial Institution of a Prescribed Class to Be Designated as a Qualifying Institution or Revocation of a Previously Granted Designation
FP-4521-V

This form must be used by any financial institution that, at any time in a particular fiscal year, is (or reasonably expects to be) a financial institution belonging to a prescribed class, and that wishes to be designated as a qualifying institution. This form must also be used in order to revoke a previously granted designation.

Note

To complete the form, save it to your computer and open it in Adobe Reader.

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2020-03 version

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