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

Regulations are current to 2017-12-11

FORM 5Annual Corporate Report of Corporations Owning Controlled Land

ALBERTAEnergy and Natural Resources

Corporation Name:
Corporation address:Address changed to:

Street:

City/Prov.:

P/Code:

Corporation access no.Date registered in Alberta:
  • 1  Is the Corporation a foreign controlled Corporation (as defined in the RegulationFootnote for *)? Yes No .

  • 2  Does the Corporation own controlled land (as defined in the RegulationFootnote for *)? Yes No .

  • 3  Total number of shares issued by the Corporation: Voting Non-Voting

Shareholders / Members

If more than 6 shareholders, use attachment (the attachment will be part of this declaration).

Name: (Surname, First, Int)
Address:
City / Prov.:
P / Code:
No. of Shares:Voting
Non-Voting
Are these shares or any of them held subject to a trust?
Yes No
Shareholder an ineligible person (as defined in the RegulationFootnote for *)?
Yes No
If a Corporation, Corporation access no.
Name: (Surname, First, Int)
Address:
City / Prov.:
P / Code:
No. of Shares:Voting
Non-Voting
Are these shares or any of them held subject to a trust?
Yes No
Shareholder an ineligible person (as defined in the RegulationFootnote for *)?
Yes No
If a Corporation, Corporation access no.
Name: (Surname, First, Int)
Address:
City / Prov.:
P / Code:
No. of Shares:Voting
Non-Voting
Are these shares or any of them held subject to a trust?
Yes No
Shareholder an ineligible person (as defined in the RegulationFootnote for *)?
Yes No
If a Corporation, Corporation access no.
Name: (Surname, First, Int)
Address:
City / Prov.:
P / Code:
No. of Shares:Voting
Non-Voting
Are these shares or any of them held subject to a trust?
Yes No
Shareholder an ineligible person (as defined in the RegulationFootnote for *)?
Yes No
If a Corporation, Corporation access no.
Name: (Surname, First, Int)
Address:
City / Prov.:
P / Code:
No. of Shares:Voting
Non-Voting
Are these shares or any of them held subject to a trust?
Yes No
Shareholder an ineligible person (as defined in the RegulationFootnote for *)?
Yes No
If a Corporation, Corporation access no.
Name: (Surname, First, Int)
Address:
City / Prov.:
P / Code:
No. of Shares:Voting
Non-Voting
Are these shares or any of them held subject to a trust?
Yes No
Shareholder an ineligible person (as defined in the RegulationFootnote for *)?
Yes No
If a Corporation, Corporation access no.

If (We) of solemnly declare that I am (President, Secretary, Director, Officer, Solicitor) of the Corporation and that the information set forth above is correct as of the date of this declaration and I 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

at the of

in the province of this day

of 19 .

(Signature)

(A Commissioner for Oaths)

(Print Name)

(Signatory’s position with the Corporation)

Date

  •  SOR/82-544, s. 2.
 
Date modified: