12. A dispensing optician must make a declaration under professional oath on a form provided by the secretary of the Order that contains the following information:
(1) the dispensing optician’s name, member number and status within the partnership or joint-stock company;
(2) the name of the partnership or joint-stock company within which the dispensing optician carries on professional activities and the registration number assigned to it by the enterprise registrar;
(3) the legal form of the partnership or joint-stock company and the fact that the partnership or joint-stock company complies with the conditions set out in section 1 and, where applicable, section 2 or 3;
(4) where a member carries on professional activities within a limited liability partnership, the address of the establishments of the partnership in Québec, specifying the address of the principal establishment, names and home addresses of all the partners, their percentage of units and an indication of their management functions, as the case may be;
(5) where the member carries on professional activities within a joint-stock company, the address of the head office of the company and of its establishments in Québec, the names and home addresses of all the shareholders, their percentage of voting shares and non-voting shares and an indication of their functions of director and officer, as the case may be; and
(6) where applicable, the date on which the general partnership became a limited liability partnership or a joint-stock company.