| Click to see instructions |
| 1. Name of Corporation |
|
| 2. Alberta Corporate Access Number |
|
| 3. Attorney Status: (Check the appropriate box) |
Attorney appointed for the purpose of registration
Change of Attorney
Alternative Attorney
Change of Alternative Attorney
Resignation / Revocation
|
| If Resignation / Revocation, name of Alternative Attorney |
|
| 4. Name of the corporation's Attorney appointed by the above mentioned corporation |
|
| 5. Full Address of Attorney (accessible to public) |
|
| Mailing Address of Attorney:(if different from above) |
|
Attorney's Consent |
| Name of Attorney |
| I, consent to act as the Attorney of the above named corporation. |
| Date |
|
| Identification of Attorney |
|
|
| Click to see instructions |
| Name of Witness |
|
| Identification of Witness |
|
| 5. Address of Witness (Street, City/ Town, Province, Postal Code) |
|
|
| Name of Person Authorizing |
|
| Telephone Number (daytime) |
|
| Date |
|
| Identification |
|
| Title |
|
|
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 3037 (Rev. 2003/05) |
| Upload Supporting Document: (Leave it blank if there is no supporting document) |
|
