Foreign Ownership of Land Regulations (SOR/79-416)

Regulations are current to 2017-09-14

FORM 4Foreign Ownership of Land Regulations

Citizenship and Corporate Ownership Declaration for Trustees*

(For Controlled Land Only)

CANADA

PROVINCE OF ALBERTA

TO WIT:

Corporation Access Number:

(for beneficiary of the trust)

IN THE MATTER of the registration of the

(name type of instrument)

affecting the land described as

(insert abbreviated description)

containing

(acres or hectares)

(name of County, M.D., I.D. or Special Area)

I (We)

of

(full address including street, municipality and country.)

SOLEMNLY DECLARE THAT:

    • 1 I (We) am (are) the transferee(s), transmittee(s), caveator(s) or lessee(s) named in the above described instrument and the item completed in the Section A which follows (or the item marked in Section B and the item marked in Section C which follows) applies in respect of the transaction represented by the above instrument.

    or

    I am a member of the Law Society of Alberta and am the solicitor for or I am a person authorized under section 22(2) of the Foreign Ownership of Land Regulations to sign on behalf of the transferee(s), transmittee(s), caveator(s) or lessee(s) named in the above described instrument and the item marked in Section A which follows (or the item marked in Section B and the item marked in Section C which follow) applies in respect of the transaction represented by the above instrument.

    • A Persons or Corporations which are not ineligible persons or foreign controlled corporations

      I (We) am (are) or the transferee(s), transmittee(s), caveator(s) or lessee(s) is (are) acting as trustee(s) for (or acting on behalf of)  of who will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and who is (are) a Canadian citizen(s) or permanent resident(s) within the meaning of the Immigration Act, 1976 (Canada). Date Landed: .

      Port of Entry: , Birth Date: and his (her or their) previous country of permanent residency was: .

      • *If there is a succession of trustees then the ultimate beneficiary must be named in the body of this declaration and a description of the succession must be attached as an exhibit forming part of the declaration.

      or

      I (We) am (are) or the transferee(s), transmittee(s), caveator(s) or lessee(s) is (are) acting as trustee(s) for (or acting on behalf of) of which will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and which is (are) not a “foreign controlled corporation(s)” or “foreign controlled limited partnership(s)” as defined in the Foreign Ownership of Land Regulations.

      or

      The Corporation(s), , is (are) acting as trustee(s) for (or acting on behalf of) of who will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person who is (are) a Canadian citizen(s) or permanent resident(s) within the meaning of the Immigration Act, 1976 (Canada). Date Landed: .

      Port of Entry: , Birth Date: and his (her or their) previous country of permanent residency was: .

      or

      The Corporation(s), , is (are) acting as trustee(s) for (or acting on behalf of) of which will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and which is (are) not a “foreign controlled corporation(s)” or “foreign controlled limited partnership(s)” as defined in the Foreign Ownership of Land Regulations.

    • B Ineligible Persons or Foreign Controlled Corporations

      I (We) am (are) or the transferee(s), transmittee(s), caveator(s) or lessee(s) is (are) acting as trustee(s) for (or acting on behalf of) from the Country of who will hold the interest in the land beneficially and who is (are) not a permanent resident(s) within the meaning of the Immigration Act, 1976 (Canada).

      or

      I (We) am (are) or the transferee(s), transmittee(s), caveator(s) or lessee(s) is (are) acting as trustee(s) for (or acting on behalf of) of which will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and which is a “foreign controlled corporation(s)” or “foreign controlled limited partnership(s)” as defined in the Foreign Ownership of Land Regulations. The majority of the shares or memberships are held by persons from the Country of .

      or

      The Corporation(s), , is (are) acting as trustee(s) for (or acting on behalf of) from the Country of who will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and who is (are) not a permanent resident(s) within the meaning of the Immigration Act, 1976 (Canada).

      or

      The Corporation(s), is (are) acting as trustee(s) for (or acting on behalf of) of which will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and which is a “foreign controlled corporation(s)” or “foreign controlled limited partnership(s)” as defined in the Foreign Ownership of Land Regulations. The majority of the shares or memberships are held by persons from the Country of .

    • C Claiming an Exemption for an interest in controlled land

      The interest is being acquired under a statutory exemption, section of the Foreign Ownership of Land Regulations. (If acquiring an interest under: 1) section 4(2), a copy of the letters probate or letters of administration must form an exhibit to this declaration and 2) section 9, a copy of the agreement must form an exhibit to this declaration;

      or

      The interest is being acquired under O.C. No. passed (day / month / year)

    • 2 The true consideration paid or payable in respect of the transactionFootnote * is as follows:

    (give full details of purchase or rental as applicable, including total price paid)

    • 3 The present value of the landFootnote *, in my opinion, is $  

    (“land includes buildings and all other improvements affixed to the land”)

    • 4 The Appendix “A” annexed hereto correctly sets forth the required information for the corporation as of the date of this declaration. Information on shares for a public corporation may be computed as of a specific time as long as that time is within 3 months of the date of the transaction being registered, however, the balance of the declaration must be as of the date of the declaration is sworn.

AND I (WE) MAKE THIS SOLEMN DECLARATION conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath.

(SEVERALLY) DECLARED before me

(print name of commissioner)

at the of

in the Province of

this day of

19 .

A Commissioner for Oaths

(signature)

(signatory’s position with the corporation, if applicable)

CONSENT OF PERMANENT RESIDENT(S)

I (We), being a permanent resident(s) give my (our) consent to the Department of Employment and Immigration (Canada) to disclose information concerning my (our) status in Canada to the Minister or someone authorized by him.

(witness)(signature)

This is Appendix “A” to the Statutory Declaration of

declared before me the day of 19 .

A Commissioner for Oaths

  • Note: This Appendix is necessary only for a corporation with share capital which is the beneficiary of the trust. Limited Partnerships, Banks, Trust Companies and Insurance Companies do not have to complete this Appendix. If a corporation is declaring that it is a foreigh controlled corporation, Appendix A does not have to be completed.

SHAREHOLDERS

List of Shareholders owning 5% or more of the outstanding shares: (Name and address)Non-foreign controlled corporation, Canadian Citizen or Permanent ResidentFootnote for 1 — Yes or NoNumber and Class of Share% of Total Outstanding SharesTo the best of my knowledge the shareholder is the Beneficial Owner and controls the Rights Attached to the Shares Yes or NoFootnote for 2
  • Return to footnote 1If a permanent resident(s), Date Landed: , Port of Entry: , Birth Date: , and his (her or their) previous country of permanent residency was: .

  • Return to footnote 2If any of the shares are held in trust or any of the rights attached to the shares are controlled through a contract or other arrangement by a person who does not own the share then list the person(s), who is (are) the ultimate beneficial owner(s) or who controls the rights attached to the shares, stating his (her or their) citizenship status and if a permanent resident the information as in one above.

List of Beneficial Owners of, or owners of the rights attached to, 5% or more of the outstanding shares: (name, address and citizenship status)

  •  SOR/80-156, s. 3.
 
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