Annual Return
Business Corporate Act

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Corporate Access No
For Year Ending
Date of Incorporation, Continuance, Amalgamation or Registration (YYYY/MM/DD)
1. Name of Corporation
2. Registered Address (Street, City/Town, Province, Postal Code)
3. Has there been any change of directors?
4. If Yes, have Corporate Registry Records been updated?
 ***If No, attach the update to this form.

5. Shareholder Information (Current)
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Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?

6. Changes in Shareholders (if applicable)
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Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
Name
Address (Street, City/Town, Province, Postal Code)
% of voting shares issued Corporate Access Number
Is Shareholder a Director?
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Telephone Number
Date (YYYY/MM/DD)
Authorized Signature: (for non-profit companies only)
Name and Title of Person Authorizing
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)
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