| Click to see instructions |
| 1. Name of Corporation (Not applicable if numbered company) |
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| 2. Corporate Access Number |
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| 3. The following persons were appointed Director(s) on (YYYY/MM/DD) |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Are you a resident Canadian? |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Are you a resident Canadian? |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Are you a resident Canadian? |
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4. The following persons ceased to hold office as Director(s) on (Not applicable if new incorporation): |
| Click to see instructions |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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5. As of this date, the Director(s) of the corporation are: (Not applicable if new incorporation): |
| Click to see instructions |
| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Are you a resident Canadian? |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Are you a resident Canadian? |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Are you a resident Canadian? |
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| Name of Director (Last, First, Second) |
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| Mailing Address (Street, City/ Town, Province, Postal Code) |
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| Are you a resident Canadian? |
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6. To be completed only by Alberta Corporations: |
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| Are at least 1/4 of the members of the Board of Directors resident Canadians? |
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| 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 3017 (Rev. 2003/05) |
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