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Corporate Access No |
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For Year Ending |
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Date of Incorporation, Continuance, Amalgamation or Registration (YYYY/MM/DD) |
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1. Name of Corporation |
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2. Registered Address (Street, City/Town, Province, Postal Code) |
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3. Has there been any change of directors? |
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4. If Yes, have Corporate Registry Records been updated? |
***If No, attach the update to this form.
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5. Shareholder Information (Current) |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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6. Changes in Shareholders (if applicable) |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Name |
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Address (Street, City/Town, Province, Postal Code) |
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% of voting shares issued |
Corporate Access Number |
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Is Shareholder a Director? |
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Click to see instructions |
Telephone Number |
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Date (YYYY/MM/DD) |
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Authorized Signature: (for non-profit companies only) |
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Name and Title of Person Authorizing |
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Provide Valid Identification Type & Number: (ex. Operator's Licence) |
(Not applicable for non-profit companies) |
7. IMPORTANT NOTICE TO CORPORATION |
This information is being collected for the purposes of corporate registry records in accordance with the Business Corporations Act. Questions about the collection of this information can be directed to the Freedom of Information and Protection of Privacy Coordinator for Alberta Registries, Box 3140, Edmonton, Alberta T5J 2G7, (780) 427-7013.
REG 3062 (Rev.2003/05) |
Upload Supporting Document: (Leave it blank if there is no supporting document) |
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