Forms Regulation (Land Titles Act)

(Consolidated up to 4/2025) ALBERTA REGULATION 480/81 Land Titles Act FORMS REGULATION 1 The forms in the Schedule are the forms prescribed for the purposes of the sections indicated on the forms. AR 480/81 s1 1.1 Repealed AR 49/2021 s2. 2 Repealed AR 159/2016 s2. 3 Repealed AR 211/2001 s2. Form 1 Repealed AR 231/99 s2. Form 1.1 Land Titles Act (Section 123) Notice to Creditor to Take Proceeding (Not more than 7 instruments may be included in this Form) Take notice that the writ of enforcement (or specify other instrument referred to in section 122) registered in the Land Titles Office on the (date) as instrument number will cease to bind or charge the land or any interest in the land legally described as (here described land) after the expiration of 60 days (or such shorter time as the judge may order) following the date on which this notice is served or sent to you by registered mail, unless in the meantime: (a) you take proceedings in court on your writ of enforcement (or other instrument) to substantiate the interest claimed by you in the above land, and (b) you file a certificate of lis pendens with the Registrar. This notice is given pursuant to section 123 of the Land Titles Act . Dated at this (date) . To (the Creditor) at (address stated in writ of enforcement or other instrument or in last filed notice of change of address for service) Signature of person giving the notice AR 331/88 s2;231/99;211/2001;251/2001;248/2006 Form 2 Repealed AR 538/82 s3. Form 2.1 Land Titles Act (Section 122) Creditor’s Statement of Debtor’s Land A.B., has an interest under the following instrument which charges or binds the interests in land of , whose address is: . The instrument is: (a) currently registered against other land with the registration number , (copy attached), or (b) attached to this statement for registration. The land in which the debtor has an interest is : (LINC number(s): ) and the debtor’s interest in the land is: . The Registrar is requested to endorse a memorandum of the instrument on the Certificate(s) of Title for this land. I am aware that the Land Titles Act provides that a creditor who files or continues the registration of a writ of enforcement or other instrument referred to in section 122(1) without reasonable cause is liable to make compensation to any person who has sustained damage as a result. Date: (Signature of creditor or agent of creditor) (Print name of person signing) (Print office held if signing for corporation) AR 48/95 s3;231/99;211/2001;251/2001 Form 3 Repealed AR 231/99 s3. Form 4 Land Titles Act (Section 35) Application to Bring Land Under the Operation of the Land Titles Act To the Registrar: I, (insert name), hereby apply to have the land hereinafter described brought under the operation of the Land Titles Act . And I declare: 1 That I am the owner (or agent for , the owner) of an estate in fee simple in possession (or of an estate of freehold in possession for my life, or Otherwise as the case may require) in that piece of land, being (here describe the land). 2 That such land, including all buildings, and other improvements thereon, is of the value of dollars and no more. 3 That there are no documents or evidences of title affecting such land in my possession, or under my control, other than those included in the schedule hereto. 4 That I am not aware of any mortgage or encumbrance affecting the said land, or that any other person has any estate or interest therein at law or in equity, in possession, remainder, reversion or expectancy (if there be any add: other than as follows: and set the same forth). 5 That the said land is now occupied (if unoccupied prefix un to occupied; if occupied, add by whom, and state the name and addition of the occupant and the nature of his occupancy). 6 That the names and addresses so far as known to me of the occupants of all lands contiguous to the said land are as follows: 7 That the names and addresses so far as known to me of the owners of all lands contiguous to the said land are as follows: (If the certificate of title is not to be granted to the applicant, add: And I direct the certificate of title to be granted in the name of (insert name).) Dated: Made and subscribed at ) in the presence of ) (Signature) AR 480/81 Form 4;231/99;251/2001 Form 5 Land Titles Act (Section 35) Affidavit Verifying Application in Form 4 I, of make oath and say: 1 That I am the applicant named in the application hereto annexed. 2 That the several statements contained in that application are true, to the best of my knowledge and belief. SWORN before me at the ) of ) in the of ) this ) (Signature) day of , ) AR 480/81 Form 5;231/99;251/2001 Form 6 Land Titles Act (Section 35) Affidavit Concerning The Hudson’s Bay Company’s Land I, of , make oath and say: 1 I am an officer of the Hudson’s Bay Company entitled to make this affidavit by the authority and under the approval of the Minister of Justice of Alberta. 2 Title to the land mentioned in the accompanying application now produced and shown to me, and marked with the letter “A”, passed to the company by notification under the provisions of subclause 7 of clause 22 of the Dominion Lands Act (or by letters patent issued-on stating date-as the case may be). 3 The company is, at the date of this affidavit, absolutely entitled to that land in fee simple and has not encumbered it in any way whatsoever. 4 And that land is not subject to any writ proceeding, and is not chargeable with any arrears of municipal taxes, rates or assessments. SWORN before me at the ) of ) in the of ) this ) (Signature) day of , ) AR 480/81 Form 6;231/99;251/2001;170/2012;216/2022 Form 7 Land Titles Act (Sections 36, 106) Receipt or Discharge by Mortgagee or Encumbrancee (Not more than 7 instruments may be included in this Form) I, , (the mortgagee, encumbrancee or transferee, as the case may be) do hereby acknowledge to have received all the money (or the sum of dollars, being part of the money,) to become due under the mortgage (or encumbrance) made by to which mortgage (or encumbrance) was registered in the Land Titles Office as instrument number , that the mortgage (or encumbrance) has not been transferred, and that the same (or, in the case of a partial discharge, the land legally described as (include legal description)) is wholly discharged (or discharged as to the sum of dollars). In witness whereof I have hereunto subscribed my name this (date) SIGNED by the above named ) ) in the presence of ) ) (Signature) AR 480/81 Form 7;538/82;231/99;251/2001;248/2006 Form 8 Land Titles Act (Section 64) Transfer I, A.B., being registered owner of an estate (state the nature of estate) subject to registered encumbrances, liens and interests, if any, in all that piece of land described as follows: (here describe land) do hereby, in consideration of (here set out true consideration) transfer to E.F., all my estate and interest in that piece of land. (When a lesser estate describe such lesser estate.) In witness whereof I have hereunto subscribed my name this (date) SIGNED by the above named ) ) A.B. in the presence of ) ) (Signature) ) AR 480/81 Form 8;538/82;231/99;251/2001 Form 9 Land Titles Act (Section 64) Grant of Easement or Right of way I, A.B., being registered owner of an estate (state nature of estate), subject to registered encumbrances, liens and interests, if any, in all that piece of land described as follows: (here describe land), do hereby in consideration of (here set out true consideration), grant to E.F., (if applicable, add: the owner of that piece of land described as follows: (here describe land) (then describe easement, right of way or other privilege intended to be created or disposed of) In witness whereof I have hereunto subscribed my name this (date) SIGNED by the above named ) ) A.B. in the presence of ) ) (Signature) ) AR 480/81 Form 9;538/82;231/99;251/2001 Form 9.1 Land Titles Act (Section 64.1(4.1)) Affidavit in Support of Transfer Levy Exception I, A.B., of , in the , make oath and say: 1 I am (one of) the transferee (or agent of the transferee) named in the within or annexed transfer. 2 I know the circumstances of the transfer and the sole purpose of the transfer is that referred to in section 64.1(4.1)(a) of the Land Titles Act . 3 I have (or the transferee has), in the capacity of a mortgagee, entered into a mortgage agreement in respect of the land described in the within or annexed transfer that complies with section 64.1(4.1)(b) of the Land Titles Act . SWORN before me at ) in the ) this day of , ) ) (Signature) AR 4/2025 s2 Form 9.2 Land Titles Act (Section 64.1(4.1)) Affidavit in Support of Transfer Levy Exception I, A.B., of , in the , make oath and say: 1 I am (one of) the transferee (or agent of the transferee) named in the within or annexed transfer. 2 I know the circumstances of the transfer and the sole purpose of the transfer is that referred to in section 64.1(4.1)(a) of the Land Titles Act . 3 I have (or the transferee has), in the capacity of a mortgagee, entered into a mortgage agreement in respect of the land described in the within or annexed transfer that complies with section 64.1(4.1)(b) of the Land Titles Act . 4 I am executing this document by two‑way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Transferee or Agent of Transferee) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 4/2025 s2 Form 10 Land Titles Act (Section 66) Transfer of Crown Interest His Majesty in right of Alberta, herein represented and acting by the Honourable Minister of being registered owner of an estate (state nature of estate), subject to registered encumbrances, liens and interests, if any, in all that piece of land described as follows: (here describe land), does hereby in consideration of (here set out true consideration) transfer to all the estate and interest of the Crown in that piece of land. (When a lesser estate describe such lesser estate.) In witness whereof the Honourable (or , Deputy Minister of ) has hereunto subscribed his name this (date) (Signature) AR 480/81 Form 10;538/82;231/99;251/2001;218/2022 Form 10.1 Land Titles Act (Section 73) Discharge of Easement, Restrictive Covenant Party Wall Agreement or Encroachment Agreement I, A.B., being the registered owner of the dominant tenement (or We, C.D., E.F., being registered owners of all the dominant tenements) described as follows: (here describe dominant land) under the easement, (restrictive covenant, party wall agreement or encroachment agreement) registered in the Land Titles Office as instrument number against the land described as follows: (here describe servient land) acknowledge that the easement, (restrictive covenant, party wall agreement or encroachment agreement) is no longer required and is wholly discharged. In witness whereof I have subscribed my name this (date) Signed by the above named A.B. ) in the presence of ) ) (Signature) AR 195/85 s3;231/99;251/2001 Form 11 Land Titles Act (Section 77) Alberta Land Surveyor’s Certificate I, (name of surveyor), of the (place of residence), Alberta Land Surveyor, make oath and say: 1 that the survey represented by this plan was made under my personal supervision, 2 that the survey was made in accordance with good surveying practices and in accordance with the provisions of the Surveys Act , and 3 that the survey was performed between the dates of and , , and that this plan is true and correct, and is prepared in accordance with the provisions of the Land Titles Act . SWORN before me at ) of ) in the of ) this day of , ) Alberta Land Surveyor AR 480/81 Form 11;231/99;251/2001 Form 11.01 Land Titles Act (Section 77) Alberta Land Surveyor’s Certificate I, (name of surveyor), of the (place of residence), Alberta Land Surveyor, make oath and say: 1 that the survey represented by this plan was made under my personal supervision, 2 that the survey was made in accordance with good surveying practices and in accordance with the provisions of the Surveys Act , 3 that the survey was performed between the dates of and , , and that this plan is true and correct, and is prepared in accordance with the provisions of the Land Titles Act , and 4 that I am executing this document by two-way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Alberta Land Surveyor) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 117/2020 s3 Form 11.1 Land Titles Act (Section 77) Monumentation Certificate I, (name of surveyor), of the (place of residence), Alberta Land Surveyor, make oath and say: 1 that the monuments required by section 47 of the Surveys Act have been placed under my personal supervision, between the dates of and , , and 2 that the position of each monument on the ground is in accordance with the co‑ordinates shown on the survey plan registered as number and that the boundaries that have been established on the ground are in accordance with the said co‑ordinates, except for the following: (List and describe any boundaries on the ground that vary from the co‑ordinates on the survey plan.) SWORN before me at ) of ) in the of ) this day of , ) Alberta Land Surveyor A.D. ) ) A Commissioner for Oaths ) in and for the Province of Alberta ) AR 211/2001 s5;251/2001 Form 11.2 Land Titles Act (Section 77) Monumentation Certificate I, (name of surveyor), of the (place of residence), Alberta Land Surveyor, make oath and say: 1 that the monuments required by section 47 of the Surveys Act have been placed under my personal supervision, between the dates of and , , 2 that the position of each monument on the ground is in accordance with the co‑ordinates shown on the survey plan registered as number and that the boundaries that have been established on the ground are in accordance with the said co‑ordinates, except for the following: (List and describe any boundaries on the ground that vary from the co‑ordinates on the survey plan.), and 3 that I am executing this document by two-way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Alberta Land Surveyor) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 117/2020 s4 Form 12 Land Titles Act (Section 77) Dominion Land Surveyor’s Certificate I, (name of surveyor), of the (place of residence), Dominion Land Surveyor, make oath and say: That the survey represented by this plan has been made by me, and that the said plan is correct and true and is prepared in accordance with the provisions of the Land Titles Act . SWORN before me at the ) of ) in the of ) this day of , ) Dominion Land Surveyor AR 480/81 Form 12;231/99;251/2001 Form 12.1 Land Titles Act (Section 77) Dominion Land Surveyor’s Certificate I, (name of surveyor), of the (place of residence), Dominion Land Surveyor, make oath and say: 1 that the survey represented by this plan has been made by me, and that the said plan is correct and true and is prepared in accordance with the provisions of the Land Titles Act , and 2 that I am executing this document by two-way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Dominion Land Surveyor) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 117/2020 s5 Form 12A Land Titles Act (Section 85) Consent to Plan of Subdivision I, A.B., having a registered interest or claimed interest by virtue of an instrument or caveat registered in the Land Titles Office as instrument number in respect of the following land: (here describe land) hereby consent to the registration of a plan of subdivision which was surveyed by , A.L.S. between and In witness whereof I have hereunto subscribed my name this (date) SIGNED by the above named ) ) A.B. in the presence of ) ) (Signature) ) AR 538/82 s4;231/99;251/2001 Form 13 Land Titles Act (Section 95) Lease I, A.B., being registered owner of an estate (state nature of estate) subject to registered encumbrances, liens and interests, if any, in all that piece of land described as follows: (here describe land) do hereby lease to E.F., all that land to be held by him as tenant, for the term of years, commencing on , at the yearly rental of dollars, payable (here insert terms of payments of rent), subject to the covenants and powers implied (also set forth any special covenants or modifications of implied covenants.) I, E.F., do hereby accept this lease of the above described land, to be held by me as tenant, and subject to the conditions, restrictions and covenants above set forth. Dated: SIGNED by the above named ) ) A.B., as lessor, and E.F., ) ) (Signature of Lessor) as lessee, in the presence ) ) of ) (Signature of Lessee) AR 480/81 Form 13;538/82;231/99;251/2001 Form 14 Land Titles Act (Section 100) Surrender of Lease In consideration of (here set out true consideration) I, E.F., the lessee (or transferee) of lease registered in the Land Titles Office as instrument number in respect of that piece of land described as follows: (here describe land) do hereby surrender and yield up from the date of to (here insert name of owner of reversionary interest) the lease and the term therein created. I, C.D., the mortgagee (or encumbrancee) under instrument number affecting the leasehold estate surrendered herein do hereby consent to the surrender of the lease. (Delete if not applicable.) Dated: SIGNED by the above named ) ) E.F., as lessee, and C.D., ) ) (Signature of Lessee) as mortgagee, in the presence ) ) of ) (Signature of Mortgagee) AR 480/81 Form 14;538/82;231/99;251/2001 Form 15 Land Titles Act (Section 102) Mortgage I, A.B., being registered owner of an estate (state nature of estate), subject to registered encumbrances, liens and interests, if any, in all that piece of land described as follows: (here describe land) in consideration of (here set out the amount and particulars of the loan or indebtedness), covenant with E.F., the mortgagee, of (here insert the mortgagee’s address): That I will repay the sum lent to me (or the indebtedness) together with interest thereon as follows: (here set out covenants for repayment of principal and interest and special covenants, if any.) And for better securing to the mortgagee the repayment in the manner set out above of the principal sum and interest (and other amounts hereby secured), I hereby mortgage to E.F. my estate and interest in the land described above. In witness whereof, I have hereunto signed my name this (date) SIGNED by the above named ) ) A.B. in the presence of ) ) (Signature of mortgagor) ) AR 480/81 Form 15;538/82;231/99;251/2001 Form 16 Land Titles Act (Section 102) Encumbrance I, A.B., being registered owner of an estate (state nature of estate), subject to registered encumbrances, liens and interests, if any, in all that piece of land described as follows: (here describe land) and desiring to render the land available for the purpose of securing to and for the benefit of C.D., of (here insert the encumbrancee’s address) the (sum of money, annuity, or rent charge) hereinafter mentioned, do hereby encumber the land described above for the benefit of C.D., with the (sum, annuity or rent charge) of to be paid at the times and in the manner following, that is to say: (here state the times appointed for the payment of the sum, annuity or rent charge intended to be secured, the interest, if any, and the events in which the sum, annuity or rent charge shall become and cease to be payable, also any special covenants or powers, and any modification of the powers or remedies given to an encumbrancee by this Act): And subject as aforesaid C.D. shall be entitled to all powers and remedies given to an encumbrancee by the Land Titles Act . In witness whereof I have hereunto subscribed my name this (date) SIGNED by the above named ) ) A.B. in the presence of ) ) (Signature of encumbrancer) ) AR 480/81 Form 16;538/82;231/99;251/2001 Form 17 Land Titles Act (Section 107) Postponement (Do not list more than 7 instruments) I, (the mortgagee, encumbrancee, caveator or as the case may be) in the (mortgage, encumbrance, caveat, lease or other instrument) registered in the Land Titles Office as instrument number hereby agree to the postponement of my rights in the following land: (here describe land) to the rights in and to that land of (the mortgagee, encumbrancee, caveator, lessor or as the case may be) in the following instrument: (here identify the instrument or instruments to be given priority; use registration number if available.) In witness whereof I have hereunto subscribed my name this (date) SIGNED by the above named ) ) in the presence of ) (Signature) ) AR 480/81 Form 17;538/82;195/85;231/99;251/2001;248/2006 Form 18 Land Titles Act (Section 109) Transfer of Mortgage, Encumbrance, or Lease (Not more than 7 instruments may be transferred under this Form) I, C.D., the mortgagee (encumbrancee or lessee, as the case may be), in consideration of dollars, this day paid to me by X.Y., of the receipt of which sum I do hereby acknowledge, hereby transfer to X.Y. (the mortgage, encumbrance or lease, as the case may be, describe the instrument fully), together with all my rights, powers, title, and interest therein. In witness whereof I have hereunto subscribed my name this (date) SIGNED by the said ) in the presence of ) C.D. (Transferor) ) AR 480/81 Form 18;231/99;251/2001;248/2006 Form 19 Land Titles Act (Section 109) Transfer of Part of Mortgage or Encumbrance I, C.D., the mortgagee (encumbrancee or lessee, as the case may be) in consideration of dollars this day paid to me by X.Y., of , the receipt of which sum I do hereby acknowledge, hereby transfer to X.Y. dollars of the mortgage (or encumbrance, as the case may be, describe the instrument fully) together with all my rights, powers, title, and interest therein, and the sum so transferred shall be preferred (or deferred or rank equally, as the case may be) to the remaining sum secured by the mortgage (or encumbrance). In witness whereof I have hereunto subscribed my name this (date) SIGNED by the said ) in the presence of ) C.D. (Transferor) ) AR 480/81 Form 19;231/99;251/2001 Form 20 Land Titles Act (Section 115) Power of Attorney I, A.B., being registered owner of an estate (here state nature of the estate or interest), subject to registered encumbrances, liens and interests, if any, do hereby appoint C.D., attorney on my behalf to (here state the nature and extent of the powers intended to be conferred, as to sell, lease, mortgage, etc.) the land described in the schedule, and to execute all instruments, and do all acts, matters and things that may be necessary for carrying out the powers hereby given and for the recovery of all rents and sums of money that may become or are now due or owing to me in respect of the land, and for the enforcement of all contracts, covenants or conditions binding on any lessee or occupier of the land or on any other person in respect of it, and for the taking and maintaining possession of the land, and for protecting it from waste, damage, or trespass. In witness whereof I have hereunto subscribed my name this (date) SIGNED by the above named ) ) A.B. in the presence of ) ) (Signature) ) AR 480/81 Form 20;538/82;231/99 Form 21 Land Titles Act (Section 115) Revocation of Power of Attorney I, A.B., of hereby revoke the power of attorney given by me to dated , and recorded in the Land Titles Office as No. In witness whereof I have hereunto subscribed my name this (date) . SIGNED by the above named ) A.B. in the presence of ) ) (Signature) AR 480/81 Form 21;231/99 Form 21.1 Land Titles Act (Section 125) Discharge of Writ of Enforcement I, A.B. the enforcement creditor under the writ of enforcement registered in the Land Titles Office as instrument number against the land described as follows: (here describe land against which the writ was endorsed at the request of the creditor) do hereby discharge the writ of enforcement (or do hereby partially discharge the writ of enforcement in respect of (here set out enforcement debtor’s name or land to be discharged or both). In witness whereof I have subscribed my name this (date) . Signed by the above named A.B. ) in the presence of ) ) (Signature) AR 195/85 s5;231/99;251/2001;248/2006 Forms 22, 23, 24 Repealed AR 231/99 s20. Form 25 Repealed AR 231/99 s21. Form 26 Land Titles Act (Section 130) Caveat Forbidding Registration Take notice that I (insert name of caveator) claim (specify the nature of the estate or interest claimed and the grounds on which the claim is founded) in the land described as follows: (here describe land) standing in the register in the name of ; and I forbid the registration of any person as transferee or owner of, or of any instrument affecting that estate or interest, unless the certificate of title is expressed to be subject to my claim. I designate the following address as the place at which notices and proceedings relating hereto may be served: In witness whereof I have hereunto subscribed my name this (date) . (Signature of Caveator or his Agent) AR 480/81 Form 26;538/82;231/99 Form 27 Land Titles Act (Section 131) Affidavit in Support of Caveat I, (the Caveator or his Agent) , make oath and say (or solemnly declare) as follows: 1 I am the within named caveator (or agent for the caveator). 2 I believe that I have (or the caveator has) a good and valid claim on the land (mortgage or encumbrance), and I say that this caveat is not being filed for the purpose of delaying or embarassing any person interested in or proposing to deal with it. Sworn before me at the ) of ) in the of ) this day of , ) AR 480/81 Form 27;195/85;231/99 Form 27.1 Land Titles Act (Section 131) Affidavit in Support of Caveat I, (the Caveator (or agent for the caveator)) , make oath and say (or solemnly declare) as follows: 1 I am the within named caveator (or agent for the caveator). 2 I believe that I have (or the caveator has) a good and valid claim on the land (mortgage or encumbrance), and I say that this caveat is not being filed for the purpose of delaying or embarrassing any person interested in or proposing to deal with it. 3 I am executing this document by two-way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Caveator (agent for the caveator)) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 117/2020 s6 Form 28 Land Titles Act (Section 132) Notice of Change of Address for Service To the Registrar: Take notice that I hereby change my address for service as stated in my caveat dated (date) filed in the Land Titles Office as No. affecting the land described as follows: and appoint as my address for service. Dated at the of in the Province of Alberta, this (date) . (Signature of Caveator or the Caveator’s Agent) AR 480/81 Form 28;231/99 Form 28A Land Titles Act (Section 136) Transfer of Caveat (Not more than 7 caveats may be transferred under this Form) I, A.B., the (agent for the) caveator under (or the (agent for the) transferee of) caveat registered in the Land Titles Office as instrument number do hereby transfer the caveat (or, in the case of a partial transfer, include legal description of land affected) to E.F. together with all rights granted by the Land Titles Act to me as caveator and subject to all liabilities imposed by the Land Titles Act on me as caveator. In witness whereof, I have hereunto subscribed my name this (date) SIGNED by the above named ) ) (Signature of Caveator or his Agent) A.B. in the presence of ) ) Notice of Change of Address for Service I, E.F. (or , agent for E.F.) designate the following address as the place at which notices and proceedings relating to the caveat or the subject matter of the caveat may be served. Dated: (Signature of Transferee or his Agent) AR 538/82 s5;231/99;251/2001;248/2006 Form 29 Land Titles Act (Section 138) Notice to Caveator to Take Proceedings on Caveat (Not more than 7 caveats may be included in this Form) Take notice that the caveat filed by you in the Land Titles Office as instrument number forbidding the registration of any person as transferee or owner of, or of any instrument affecting, the estate or interest claimed in your caveat in respect of the land (or, in the case of a partial lapse include legal description of land affected), unless the certificate of title is expressed to be subject to your claim, will cease to have any effect after the expiration of 60 days (or such shorter time as the judge may order) following the date on which this notice is served or sent to you by registered mail, unless in the meantime (a) you take proceedings in court on your caveat to substantiate the interest claimed by you in the above land, and (b) you file a certificate of lis pendens with the Registrar. This notice is given pursuant to section 138 of the Land Titles Act . Dated at on (date) . To (the Caveator) at (address stated in the caveat or address stated in the last notice of change of address for service filed in the Land Titles Office) (Signature of person giving the notice) AR 480/81 Form 29;195/85;331/88;231/99;251/2001;248/2006 Form 30 Land Titles Act (Sections 123, 138 and 148) COURT FILE NUMBER Clerk’s Stamp: COURT OF KING’S BENCH OF ALBERTA JUDICIAL CENTRE PLAINTIFF(S) DEFENDANT(S) DOCUMENT CERTIFICATE OF LIS PENDENS ADDRESS FOR SERVICE AND CONTACT INFORMATION OF PARTY FILING THIS DOCUMENT This is to certify that in this action a claim has been made to enforce an interest in land or some title or interest in land is called into question, as follows: (here give particulars of the claim, and include registration particulars of any registered instrument or caveat affected by the action) in respect of the following land: (here describe land). Dated at , Alberta, on (date) . (Court Clerk) AR 480/81 Form 30;195/85;231/99;211/2001; 251/2001;164/2010;227/2011;218/2022 Form 30A Land Titles Act (Section 152) Withdrawal of Certificate of Lis Pendens I, A.B., the in court proceedings (here set out particulars of the court action) and the person on whose behalf a certificate of lis pendens was registered in the Land Titles Office as instrument number do hereby withdraw the certificate of lis pendens (or, in the case of a partial withdrawal, include the legal description of the land affected). In witness whereof, I have hereunto subscribed my name this (date) SIGNED by the above named ) A.B. in the presence of ) ) (Signature) ) AR 538/82 s6;231/99;251/2001;248/2006 Form 31 Repealed AR 248/2006 s3. Form 31 Land Titles Act (Sections 155 and 156) Affidavit of Attestation of an Instrument I, A.B., of , in the make oath and say: 1. I was personally present and did see who is known to me to be the person named in the within (or annexed) instrument, duly sign the instrument; or I was personally present and did see who, on the basis of the identification provided to me, I believe to be the person named in the within (or annexed) instrument, duly sign the instrument; 2. The instrument was signed at , in the and I am the subscribing witness thereto; 3. I believe the person whose signature I witnessed is at least eighteen (18) years of age. Sworn before me at ) in the ) this day of , ) ) (Signature) Or Form 31 Land Titles Act (Sections 155 and 156) Affidavit of Attestation of an Instrument by Marksman I, A.B., of , in the , make oath and say: 1. I was personally present and did see who is known to me to be the person named in the within (or annexed) instrument duly execute the instrument by making his mark on it; or I was personally present and did see who, on the basis of the identification provided to me, I believe to be the person named in the within (or annexed) instrument, duly execute the instrument by making his mark on it; 2. The instrument was read over and fully explained to the person whose execution by mark I witnessed before it was executed and he seemed to fully understand it; 3. The instrument was executed at in the and I am the subscribing witness thereto; 4. I believe the person whose execution by mark I witnessed is at least eighteen (18) years of age. Sworn before me at ) in the ) this day of , ) ) (Signature) AR 480/81 Form 31;331/88;231/99;251/2001;149/2007 Form 31.01 Land Titles Act (Sections 155 and 156) Affidavit of Attestation of an Instrument I, A.B., of , in the make oath and say: 1. I, , being a lawyer in and for the Province of Alberta: (a) witnessed the signature of named in the within instrument, in a single session during which I was able at all times to see and hear the person signing the instrument by two-way video conferencing; (b) witnessed named in the within instrument, who is personally known to me to be the person named in the within (or annexed) instrument, duly sign and execute the instrument; (c) have complied with the requirements established by the Law Society of Alberta, with respect to this type of witnessing in effect at the date of this affidavit; or I, , being a lawyer in and for the Province of Alberta: (a) witnessed the signature of named in the within instrument, in a single session during which I was able at all times to see and hear the person signing the instrument by two-way video conferencing; (b) witnessed , who, on the basis of identification shown to me, I believe to be the person named in the within (or annexed) instrument, duly sign and execute the instrument; (c) have complied with the requirements established by the Law Society of Alberta, with respect to this type of witnessing in effect at the date of this affidavit; 2. t he instrument was signed at , in the and I am the subscribing witness thereto; 3. I believe the person whose signature I witnessed is at least eighteen (18) years of age; 4. I am executing this document by two-way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Deponent) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) Or Form 31.01 Land Titles Act (Sections 155 and 156) Affidavit of Attestation of an Instrument by Marksman I, A.B., of , in the , make oath and say: 1. I, , being a lawyer in and for the Province of Alberta: (a) witnessed the signature of named in the within instrument, in a single session during which I was able at all times to see and hear the person making their mark on the instrument by two‑way video conferencing; (b) witnessed named in the within instrument, who is personally known to me to be the person named in the within (or annexed) instrument, duly execute the instrument by making their mark on the instrument; (c) have complied with the requirements established by the Law Society of Alberta, with respect to this type of witnessing in effect at the date of this affidavit; or I, , being a lawyer in and for the Province of Alberta: (a) witnessed the signature of named in the within instrument, in a single session during which I was able at all times to see and hear the person making their mark on the instrument by two‑way video conferencing; (b) witnessed , who, on the basis of identification shown to me, I believe to be the person named in the within (or annexed) instrument, duly execute the instrument by making their mark on the instrument; (c) have complied with the requirements established by the Law Society of Alberta, with respect to this type of witnessing in effect at the date of this affidavit; 2. the instrument was read over and fully explained to the person whose execution by mark I witnessed before it was executed and he/she seemed to fully understand it; 3. the instrument was executed at in the and I am the subscribing witness thereto; 4. I believe the person whose execution by mark I witnessed is at least eighteen (18) years of age; 5. I am executing this document by two-way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Deponent) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 117/2020 s7 Form 31.1 Land Titles Act (Section 161) Affidavit Verifying Corporate Signing Authority I, A.B. of make oath and say: 1 I am an officer or a director of (here set out name of corporation) named in the within or annexed instrument (or caveat). 2 I am authorized by the corporation to execute the instrument (or caveat) without affixing a corporate seal. SWORN before me at ) in the ) this day of , ) ) (Signature) AR 195/85 s10;231/99;251/2001 Form 31.2 Land Titles Act (Section 161) Affidavit Verifying Corporate Signing Authority I, A.B. of make oath and say: 1. I am an officer or a director of (here set out name of corporation) named in the within or annexed instrument (or caveat). 2. I am authorized by the corporation to execute the instrument (or caveat) without affixing a corporate seal. 3. I am executing this document by two‑way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Officer or Director) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 117/2020 s8 Form 32 Land Titles Act (Section 164) Affidavit re Value of Land I, A.B., of , in the make oath any say: 1. I am (one of) the transferee (or agent of the transferee) named in the within or annexed transfer and I know the land therein described; 2. I know the circumstances of the transfer and true consideration paid by me is as follows: (Give full details: cash, assumption of mortgage, exchange or other consideration with cash value of same.) 3. The current value* of the land**, in my opinion, is $______________. * “value” means the dollar amount that the land might be expected to realize if it were sold on the open market by a willing seller to a willing buyer. ** “land” includes buildings and all other improvements affixed to the land. SWORN before me at ) in the ) this day of , ) ) (Signature) AR 480/81 Form 32;331/88;231/99;251/2001;326/2003 Form 32.1 Land Titles Act (Section 164) Affidavit re Value of Land I, A.B., of , in the make oath any say: 1. I am (one of) the transferee (or agent of the transferee) named in the within or annexed transfer and I know the land therein described. 2. I know the circumstances of the transfer and true consideration paid by me is as follows: (Give full details: cash, assumption of mortgage, exchange or other consideration with cash value of same.) 3. The current value* of the land**, in my opinion, is $ . * “value” means the dollar amount that the land might be expected to realize if it were sold on the open market by a willing seller to a willing buyer. ** “land” includes buildings and all other improvements affixed to the land. 4. I am executing this document by two‑way video conferencing separate and apart from any other person. SWORN BEFORE ME, , ) a lawyer in and for the Province of Alberta ) at the in the ) of by two‑way video conferencing ) with the deponent who was at the ) in the Province of Alberta this day of ) , on the basis of evidence ) provided to me that enabled me to verify the ) (Transferee or Agent of Transferee) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) AR 117/2020 s9 Form 33 Land Titles Act (Section 179) Mineral Certificate I hereby certify that at the date of this disposition from to dated purporting to dispose of the following interest in mines and minerals, namely (state mines and minerals shown in disposition) was the correct registered (name of registered owner) owner under Certificate of Title No. of all (state mines and minerals shown in title) within, on or under Dated: . Registrar, AR 480/81 Form 33;232/82;231/99;251/2001 Form 34 Land Titles Act (Section 185) COURT FILE NUMBER Clerk’s Stamp: COURT OF KING’S BENCH OF ALBERTA JUDICIAL CENTRE APPLICANT Registrar of Land Titles DOCUMENT REFERENCE UNDER THE LAND TITLES ACT ADDRESS FOR SERVICE AND CONTACT INFORMATION OF PARTY FILING THIS DOCUMENT Reference to the Court under section 185 of the Land Titles Act . Basis for the reference to be put before the Court: 1. This reference relates to the registration of transfer (or as the case may be) A.B. to C.D. 2. The Registrar under section 185 of the Land Titles Act hereby refers the following matter to the judge: (here state briefly the difficulty that has arisen) . 3. The parties interested, so far as the Registrar knows or has been informed, are: (here give the names) . (Signature) (Official seal) Registrar AR 480/81 Form 34;251/2001;227/2011;218/2022 Form 35 Land Titles Act (Section 187) Demand to Return Instrument TO (name of owner or whoever is custodian of instrument) . You are hereby required to forward to the Land Titles Office instrument registered as No. , affecting the following lands for (description of land) as the same is required by me pursuant to the provisions of the Land Titles Act for the purpose (purpose for which the instrument is required and whether or not by direction of a judge). Your attention is called to the provisions of sections 187 and 189 of that Act, and the penalty therein provided for neglect or refusal to comply with this demand. A.B., Registrar AR 480/81 Form 35;231/99;251/2001