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| 1. Name of Corporation |
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| 2. Corporate Access Number |
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| 3. Address of Registered Office (Street, City/ Town, Province, Postal Code or P.O. Box number can only be used by a Society) |
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| Or Legal Land Description (Section, Township, Range, Meridian) |
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| 4. Records Address (Street, City/ Town, Province, Postal Code, P.O. Box number cannot be used) |
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| Or Legal Land Description (Section, Township, Range, Meridian) |
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| 5. Address for Service by Mail (if different from Item 3) NOTE: If this is a change, please read instructions carefully
(Post Office Box Only, City / Town, Province, Postal Code) |
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| Click to see instructions |
| Authorized Signature (for societies and non-profit companies only) |
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| Name of Person Authorizing |
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| Date |
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| Telephone Number (daytime) |
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| Valid Identification Type & Number (not applicable for societies and non-profit companies) |
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| Title |
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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 3016 (Rev. 2003/05) |
| Upload Supporting Document: (Leave it blank if there is no supporting document) |
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