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AR 231/2002 PERSONAL PROPERTY SECURITY FORMS REGULATION

(Consolidated up to 159/2015)

ALBERTA REGULATION 231/2002

Personal Property Security Act

PERSONAL PROPERTY SECURITY FORMS REGULATION

Forms prescribed

1   The forms in the Schedule are prescribed for the purposes of the Personal Property Security Act and the Personal Property Security Regulation (AR 95/2001).


Repeal

2   The Personal Property Security Forms Regulation (AR 295/90) is repealed.

3   Repealed AR 159/2015 s2.

Schedule   

Form 1

                                                              PPSA Security Agreement,  Sale of Goods Act s.26(2)                                                                         or Factors Act s.9(2)

Alberta_black(                                                Financing Statement

Type of Registration (Select one only)

SA

   PPSA Security Agreement

1.  What is the term of Registration?

       (1‑25 years) or
    Infinity

2.  Does it cover Trust Indenture?

      Yes       No

SG

   Sale of Goods Act s.26(2) or Factors Act s.9(2)

1.  What is the term of Registration?

     (1‑25 years) or     Infinity

Debtor One

Select one        Business                   Individual

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

Debtor Two

Select one         Business                   Individual

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                    (Postal Code)

Secured Party

Select one          Business                 Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Collateral ‑ Serial Number Goods

(If PPSA, applicable only to consumer goods or equipment)

1  (Serial Number)          (YYYY)          (Make and Model)        (Category)

2  (Serial Number)          (YYYY)          (Make and Model)        (Category)

General Collateral

1                                                                                                             

2                                                                                                             

(Your Reference No.)

                                             (Name of Person Authorized       (Phone          (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                     No.)

Form 1.1

                                                                          Writ of Seizure and Sale

                                                                                          (Federal Writ)

                                                                             Civil Enforcement Act

Alberta_black(                                                Financing Statement

  (Court Location)                                 (Writ File Number)                    

This Writ authorizes enforcement proceedings in accordance with the Civil Enforcement Act.  The particulars of the Writ are as follows:

Debtor

Select one      Business      Individual               (Occupation)         

 (Business Name or Last Name)  (First Name)                                    (Middle Name)    
 Gender  
  M       F                     (birthdate if known (dd/mm/yy))      

(Street Address)                      (City)             (Province)                         (Postal Code)

Creditor/Agent

Select one          Business                  Individual

Personal Property Registry

    (P.P.R.) Party Code                   (Name in Full)                                         

(Street Address)                      (City)             (Province)                         (Postal Code)

(Telephone Number)    (Fax Number)   (Call Box Number)     (Reference Number)   

  Additional Debtors and Creditors and/or other information listed on attached addendum.

  If claiming priority based on an Attachment Order, indicate previous P.P.R. Registration Number.   

Date of Judgment (or date Judgment effective, if different)
   (day)    day of    (month)   ,    (year)   .

Original Judgment            $               

Post Judgment Interest     $               

Costs                                $               

Current Amount Owing $               

To Register Against Serial # Goods at Personal Property Registry, Complete the Following:

Serial No. (Only applicable

to serial no. goods,

e.g. motor vehicles)            (YYYY)        Make and Model            Category
                                                                                                               
                                                                                                               

                                                              (Name of Person Authorized     

(Authorized Signature)                             to Complete this form (PRINT))

Form 1.2

                                                                          Writ of Seizure and Sale

                                                                                          (Federal Writ)

                                                                             Civil Enforcement Act

Alberta_black(                                                Financing Statement

                                                                                             Addendum

Debtor

Select one       Business         Individual           (Occupation)          

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

    (Debtor’s Block Number (if adding alias))   

Debtor

Select one       Business         Individual           (Occupation)          

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

    (Debtor’s Block Number (if adding alias))   

Collateral ‑ Serial Number Goods

Serial No.               (YYYY)                 Make and Model                Category
                                                                                                               
                                                                                                               

Additional Information

                                                                                                               
                                                                                                               

Form 1.3

Alberta_black(                                                    Receiver’s Report,

                                                                               Orders or Charges

                                                                            Financing Statement

Type of Registration (Select one only)

  Receiver’s Report

  Court Order ‑ Court Location     (Court File Number)     (Date Order Granted)  

  Matrimonial Property Order
  Statutory Charge ‑ Amount                                     
  Crown Charge
  Land Charge

Debtor

Select one           Business                    Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                    (Postal Code)

Secured Party

Select one           Business                  Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Solicitor/Agent   (If Court Order or Receiver’s Report)

Personal Property Registry

    (P.P.R.) Party Code                   (Name in Full)                                         

(Street Address)                      (City)             (Province)                         (Postal Code)

(Telephone Number)    (Fax Number)   (Call Box Number)     (Reference Number)   

Collateral ‑ Serial Number Goods

Serial No.               (YYYY)                 Make and Model                Category
                                                                                                               
                                                                                                               

General Collateral
(If Court Order, Matrimonial Property Order, Statutory Charge or Crown Charge)

                                                                                                               
                                                                                                               

(Your Reference No.)

                                             (Name of Person Authorized       (Phone          (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                     No.)

Form 2

Alberta_black(                                          Debtor/Secured Party or

                                                                    Solicitor/Agent Additions

Debtor

Select one           Business                    Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

Debtor

Select one           Business                    Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                    (Postal Code)

Debtor

Select one           Business                    Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                    (Postal Code)

Secured Party

Select one           Business                  Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Secured Party

Select one          Business                  Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Solicitor/Agent   (If Court Order or Receiver’s Report)

Personal Property Registry

    (P.P.R.) Party Code                   (Name in Full)                                         

(Street Address)                      (City)             (Province)                         (Postal Code)

(Telephone Number)    (Fax Number)   (Call Box Number)     (Reference Number)   

Form 3

Alberta_black(                            Serial Number Goods Additions

Collateral ‑ Serial Number Goods

(If PPSA, applicable only to consumer goods or equipment)

Serial Number                          (YYYY)       Make and Model       Category

                                                                                                               

                                                                                                               

Form 4

Alberta_black(                                   General Collateral Additions

General Collateral – Description

                                                                                                            

                                                                                                            

Form 5

Alberta_black(                                        Additions and Deletions ‑

                                                              Court Order, Other Changes

                                                                 and Additional Information

Deletions
Select type of particulars:

                 Court Order

                       Particulars:

                 Other Changes

                       Particulars:

                 Additional Information

                       Particulars:

 

Block Number / Description
                                                                                                               
                                                                                                               

Additions
Select type of particulars:

                 Court Order

                       Particulars:

                 Other Changes

                       Particulars:

                 Additional Information

                       Particulars:

 

Block Number / Description
                                                                                                               
                                                                                                               

Form 6

Alberta_black(                                  Financing Change Statement

Identification of Registration or Amendments

 (Latest Registration No.)

Current Debtor

(Business Name or Last Name)     (First Name)               (Middle Name)

Current Secured Party

(Business Name or Last Name)     (First Name)               (Middle Name)

Place an (X) in the appropriate space

       Renewal ‑     For PPSA, Sale of Goods Act and Factors Act, please give the following:
                                       (1‑25 years), or
                                       Infinity

      Change -       Deletions/Additions

      Total Discharge ‑     permanently remove ALL record of     registration(s)

Deletions

Debtor

(Block No.)  (Business Name or Last Name) (First Name)  (Middle Name)

Secured Party

(Block No.)  (Business Name or Last Name) (First Name)  (Middle Name)

Collateral ‑ Serial Number Goods

(Block No.)      (Serial No.)      (YYYY)      (Make and Model)   (Category)

NOTE:             To DELETE other collateral, complete and attach:

                         Form 8 - Collateral Deletions

Additions

Debtor

Select one           Business                   Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

Secured Party

Select one           Business                  Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Collateral ‑ Serial Number Goods

(If PPSA, applicable only to consumer goods or equipment)

(Serial Number)          (YYYY)          (Make and Model)        (Category)

NOTE:                 To ADD other collateral, complete and attach:

                             Form 3 - Serial Number Goods Additions, and/or

                             Form 4 - General Collateral Additions

(Your Reference No.)

                                             (Name of Person Authorized       (Phone          (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                     No.)

Form 7

Alberta_black(                                          Debtor/Secured Party or

                                                                    Solicitor/Agent Deletions

Debtor

Select one           Business                    Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

Debtor

Select one           Business                    Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                    (Postal Code)

Debtor

Select one           Business                    Individual

If Court Order, indicate
Occupation                                                                 Gender 
  M      F

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                    (Postal Code)

Secured Party

Select one           Business                  Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Secured Party

Select one          Business                  Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Solicitor/Agent   (If Court Order or Receiver’s Report)

Personal Property Registry

    (P.P.R.) Party Code                   (Name in Full)                                         

(Street Address)                      (City)             (Province)                         (Postal Code)

(Telephone Number)    (Fax Number)   (Call Box Number)     (Reference Number)   

Form 8

Alberta_black(                                                  Collateral Deletions

Serial Number Goods

Block No.    Serial No.    (YYYY)    Make and Model               Category

                                                                                                            

                                                                                                            

                                                                                                            

General Collateral

Block No.                 Description

                                                                                                            

                                                                                                            

                                                                                                            

Form 9

Alberta_black(                                              Garage Keepers’ Lien

                                                                            Financing Statement

Registration Details

              NOTE:       In these questions, the words “you” and “your”              refer to the person claiming the lien.

1.   Did you repair or store the vehicle?                           No         Yes   

If yes, complete the following:

          a.   Do you still have possession of the vehicle?       No         Yes   

If yes, proceed to question 3:  

          b.   If repaired or stored on your premises, when

                did you release it?                                                   (dd/mm/yy)    

          c.   If repaired off your premises, when did you finish the                           repairs?                                                                    (dd/mm/yy)    

2.   Did you provide accessories or parts for the vehicle?    No         Yes

If yes, when were they provided:      (dd/mm/yy)    

3.   How much is the lien (in dollars and cents)?          $                         

Vehicle Owner(s)

Owner 1         Select one             Business                Individual

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

Owner 2         Select one             Business                Individual

Birthdate

(if known)

(Business Name or Last Name)    (First Name)    (Middle Name)             (dd/mm/yy)

(Street Address)                    (City)     (Province)                                   (Postal Code)

Person Claiming Lien

Select one            Business                     Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Describe Motor Vehicle, Farm Vehicle, Aircraft or Boat

(Serial No.)             (YYYY)             (Make and Model)              (Category)

(Your Reference No.)

                                         (Name of Person Authorized         (Phone            (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                        No.)

Form 10

Alberta_black(                                              Garage Keepers’ Lien

                                                              Financing Change Statement

Identification of Registration or Amendments

(Latest Registration No.)

Current Vehicle Owner

(Business Name or Last Name)            (First Name)             (Middle Name)

Current Person Claiming Lien

(Business Name or Last Name)            (First Name)             (Middle Name)

Changes to be Made

Place an (X) in the appropriate space

        Total Discharge (If selected, ALL record of registration(s) will be permanently removed.)

        Court Order                                  Renewal, and/or

                                                             Amendment

a.      What is the date of the Court Order?                         (dd/mm/yy)    

b.     In which Judicial District was the Order made?                               

c.      What is the Court File Number?                                                      

d.     If the court has extended time for seizure,

        enter the new date:              (dd/mm/yy)    

e.      If Amendment is selected, you must attach additional forms as required.

(Your Reference No.)

                                         (Name of Person Authorized         (Phone            (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                        No.)

Form 11

Alberta_black(                                                      Global Financing

                                                                                Change Statement

Current Secured Party/Solicitor/Agent/Civil Enforcement
Agent Information

(Current
Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Distribution Method   Mail    Print    Call Box    Fax    E‑mail

         (Call Box Number)             (Fax Number)             (E‑mail Address)    

Complete Either A or B Below:

A.        Change of Name or Address for:

Select one    Current Secured Party 
                  
  Current Solicitor/Agent
                  
  Current Civil Enforcement Agent

New Name or Address

Select one           Business                   Individual

(New Business Name or Last Name)               (First Name)               (Middle Name)

(New Street Address)                  (City)                  (Province)               (Postal Code)

B.        Change of Party Code for:

Select one    Secured Party
                  
  Solicitor/Agent
                  
  Civil Enforcement Agent

New Party Code

Select one          Business                   Individual

(New Business Name or Last Name)               (First Name)               (Middle Name)

(New Street Address)                  (City)                  (Province)               (Postal Code)

Transmitting Party

Select one          Business                  Individual

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

(Your Reference No.)

                                             (Name of Person Authorized       (Phone          (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                     No.)

Form 12

Alberta_black(                                                  Search Request for

                                                                              Expired/Discharged

                                                                       Registration Number(s)

Person Requesting Search

(Secured

Party Code)         (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)                      (City)             (Province)                         (Postal Code)

Payment Type   Cash              Cheque            Account

Distribution Method   Mail    Print    Call Box    Fax    E‑mail

         (Call Box Number)             (Fax Number)             (E‑mail Address)    

Registration Number(s)

                                                                                                               

                                                                                                               

                                                                                                               

(Your Reference No.)

                                             (Name of Person Authorized       (Phone          (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                     No.)

Form 13

Alberta_black(                                     Search Request for Debtor

                                                                  Name(s), Serial Number(s)

                                                           and/or Registration Number(s)

Person Requesting Search

(Secured

Party Code)

(if applicable)      (Business Name or Last Name)     (First Name)     (Middle Name)

(Street Address)               (City)                      (Province)                               (Postal Code)

Payment Type   Cash              Cheque            Account

Distribution Method   Mail    Print    Call Box    Fax    E‑mail

         (Call Box Number)             (Fax Number)             (E‑mail Address)    

Debtor Name(s) Search

Select one           Business                  Individual

                                                                                                  Birthdate

                                                                                               (if known)

1   (Business Name or Last Name)    (First Name)    (Middle Name)        (dd/mm/yy)

Select one           Business                 Individual

                                                                                                  Birthdate

                                                                                               (if known)

2   (Business Name or Last Name)    (First Name)    (Middle Name)        (dd/mm/yy)

Serial Number(s) Search

1   (Serial Number)     (YYYY)           (Make and Model)    (Category)

2   (Serial Number)     (YYYY)           (Make and Model)    (Category)

Registration Number(s) Search

1                                                                                                             

2                                                                                                             

(Your Reference No.)

                                             (Name of Person Authorized       (Phone          (Call Box

(Authorized Signature)  to Complete this form (PRINT))   No.)                     No.)

Form 14

Alberta_black(                                       Demand to Secured Party

                                                          Personal Property Security Act

                                                                                           Section 50(3)

To:                 (Name of Secured Party)                                                  

1.         A Financing Statement was registered in your favour and assigned registration number

                (Registration No.)       on the  (day)  day of  (month) ,  (year)  at the Personal Property Registry.

2.         I am named as the debtor in the Financing Statement.

OR

            I have an interest in property that falls under the collateral description in the Financing Statement

                       (Describe interest)                                                            

3.         Pursuant to section 50 of the Personal Property Security Act, you are hereby required, not later than 40 days after this demand is given,

                                        (a)    to register a Financing Change Statement for the purpose of

                                                      Describe type of change demanded (i.e. discharge or amendment of collateral description)                                                                     

OR

                                       (b)    to provide to the Registrar an Order of the Court confirming that the registration need not be amended or discharged.

4.         If this demand is not complied with, I intend to submit a Financing Change Statement for the registration pursuant to section 50(5) of the Personal Property Security Act.

            Dated this    (day)    day of    (month)  ,    (year)    .

            Person giving Demand:                  (Please PRINT)                

                                                                              (Signature)                

Form 15

Alberta_black(                                                  Proof of Demand to

                                                                                       Secured Party

                                                          Personal Property Security Act

                                                                                           Section 50(5)

Statutory Declaration

I,                                                                                                       of     (Address)     in the Province of                    ,    (Postal Code)   

DO SOLEMNLY DECLARE THAT:

1.         A Financing Statement was registered in the Personal Property Registry and assigned registration number    (registration no.)    on the    (day)    day of      (month)     ,    (year)  .

2.         I am named as the debtor in the Financing Statement

OR

            I have an interest in property that falls under the collateral description in the Financing Statement

                               (Describe interest)                                                    

3.         Attached to this declaration and marked as Exhibit A is a copy of the Demand to Secured Party which was given to          (Name of Secured Party)        .

4.         Service of Exhibit A was effected on the secured party on    (day)    day of      (month)    ,    (year)   , by    (Type of delivery method)      as evidenced by the proof of service attached to this declaration and marked as Exhibit B.  (Attach post office receipt or affidavit verifying service in some other authorized manner.)

5.         The prescribed 40‑day period for registering a Financing Change Statement or providing an Order of the Court to the Registrar has expired.

6.         I have the authority to submit for registration a Financing Change Statement pursuant to section 50 of the Personal Property Security Act.

AND I MAKE THIS SOLEMN DECLARATION CONSCIENTIOUSLY BELIEVING IT TO BE TRUE AND KNOWING THAT IT IS OF THE SAME FORCE AND EFFECT AS IF MADE UNDER OATH.

Declared before me                                                                                )

at the              of                                                                                     )

in the province of                                                                                   )        (Signature)      

on    (day)    day of      (month)    ,    (year)                                            )

Form 16

Alberta_black(                                       Notice of Security Interest

                                                                               (Fixtures or Crops)

                                                          Personal Property Security Act

                                                                                           Section 49(2)

TAKE NOTICE that a security interest has been created in collateral that is or may become a fixture or crop on land and that the particulars of the security interest are set out as follows:

Debtor

(Business Name or Last Name)                      (First Name)                 (Middle Name)

(Street Address)                                     (City)            (Province)            (Postal Code)

Legal description of land upon which the collateral is or will be located or affixed and LINC if known

Secured Party

(Business Name or Last Name)                      (First Name)                 (Middle Name)

(Street Address)                                     (City)            (Province)            (Postal Code)

Amount Secured

$                                       

Description of Collateral

                                                                                                               
                                                                                                               

AND that this notice will expire the      (day)      of        (month)        ,       (year)       .

Dated this    (day)    day of      (month)    ,    (year)    at            Alberta.

                   (signature)                              (Name - Please PRINT)          

Secured Party or Agent                                        Secured Party or Agent

Form 17

Alberta_black(                                                          Change Notice

                                                                               (Fixtures or Crops)

                                                          Personal Property Security Act

                                                                                           Section 49(4)

TAKE NOTICE that the security interest in respect of which

                               (a)                                                                                                       is the secured party,
                                                             and                              

                               (b)    a notice was registered in the Land Titles Office as instrument number                           against the land described as follows:

                                                 (Give legal description and LINC if known)           has been:

Mark “X” beside the appropriate statement and complete particulars

     renewed until    (day)    of     (month)    ,    (year)  

      transferred to (name and address of transferee)

      postponed to the interest under instrument/caveat number           being       (describe nature of interest)       in favour of                                      

      amended by:    (describe nature of change)   

      partially discharged as to the land described as follows:

      wholly discharged.

 

Dated this    (day)    day of      (month)    ,    (year)      .

Signed by                                               in the presence of    (witness)   

               (Signature of Secured Party or Agent)                  

Form 18

Alberta_black(                                        Affidavit Verifying Notice

                                                     Personal Property Security Regulation

                                                                                           Section 66(1)

I,                                          of                                        in the Province of                          .      (postal code)     make oath and say:

1.       That I have been authorized by the secured party to act as an agent for the purpose of effecting registration of notices relating to a security interest in a fixture or crop on the land described in the attached notice.

2.       That I have full knowledge of the facts set out in the attached notice and the statement of facts is true.

Sworn before me                                )

this   (day)  day of   (month)  ,   (year)  )               (Signature of agent)        

at                       , Alberta.                      )

Form 19

Alberta_black(                                       Demand to Secured Party

                                                                               (Fixtures or Crops)

                                                          Personal Property Security Act

                                                                                           Section 49(7)

To:       (Name of Secured Party)      

1.       A Notice of Security Interest was registered in your favour and assigned as instrument number      (Instrument No.)     on the    (day)    day of     (month)   ,    (year)    at the Land Titles Office at                                      against the land described as follows:

          (Give legal description and LINC if known)

2.       I am named as the debtor in the Notice of Security Interest.

OR

          I have an interest in the land as follows:

          (Describe nature of interest)                                                              

          pursuant to instrument/caveat no.                                                 .

3.       Pursuant to section 49 of the Personal Property Security Act, you are hereby required, not later than 40 days after this demand is given, to submit for registration

                                        (a)    a Change Notice for the purpose of

                                                   (Describe type of change demanded (i.e. discharge or amendment of collateral description)                     

OR

                                       (b)    an Order of the Court confirming that the registration need not be amended or discharged.

4.       If this demand is not complied with, I intend to submit a Change Notice for registration pursuant to section 49(9) of the Personal Property Security Act.

          Dated this    (day)    day of    (month)   ,    (year)   .

          Person giving Demand:                               (Please PRINT)         

                                                                                (Signature)               

Form 20

Alberta_black(                                  Proof of Demand to Secured

                                                                     Party (Fixtures or Crops)

                                                          Personal Property Security Act

                                                                                           Section 49(9)

Statutory Declaration

I,                                                                                                          of     (Address)     in the Province of                   ,    (postal code)   

DO SOLEMNLY DECLARE THAT:

1.       A Notice of Security Interest was registered in the Land Titles Office as instrument number                  against the following land:

                 (Give legal description and LINC if known)                              

2.       I am named as the debtor in the Notice of Security Interest

OR

          I have an interest in the land as follows:

                   (Describe nature of interest)                                                      

          pursuant to instrument/caveat no.                                                       .

3.       Attached to this declaration and marked as Exhibit A is a copy of the Demand to Secured Party which was given to        (Name of Secured Party)      .

4.       Service of Exhibit A was effected on the secured party on    (day)    day of      (month)    ,    (year)    by    (Type of delivery method)    as evidenced by the proof of service attached to this declaration and marked as Exhibit B.  (Attach post office receipt or affidavit verifying service in some other authorized manner.)

5.       The prescribed 40‑day period for submitting a Change Notice or Order of the Court for registration has expired.

6.       I have the authority to submit for registration a Change Notice pursuant to section 49 of the Personal Property Security Act.

AND I MAKE THIS SOLEMN DECLARATION CONSCIENTIOUSLY BELIEVING IT TO BE TRUE AND KNOWING THAT IT IS OF THE SAME FORCE AND EFFECT AS IF MADE UNDER OATH.

Declared before me                                                                                )

at the            of                                                                                       )

in the province of                                              )            (Signature)        

on    (day)    day of      (month)    ,    (year)                                            )

Form 21

Alberta_black(

 

Filed

Civil Enforcement Act

Writ of Enforcement
Financing Statement

                                                                Type of Judgment                    

(Court Location)           (Court File No.)              Crown                          

                                                                            Employment Standards

                                                                           Other                            

This Writ authorizes enforcement proceedings in accordance with the Civil Enforcement Act.  The particulars of the Writ are as follows:

Debtor

Select one                  Business                  Individual

                                                                                  (Occupation)          

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

(Street Address)                 (City)                     (Province)                                (Postal Code)

Creditor

Select one                  Business                  Individual

(Personal

Property Registry

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)             (City)                      (Province)                    (Postal Code)     

        Additional Debtors and Creditors and/or other information listed on attached addendum.

        If claiming priority based on an Attachment Order or partial Assignment, indicate previous PPR Registration Number.

Date of Judgment (or date Judgment effective, if different)
   (day)    day of    (month)   ,    (year)   .

This Writ is issued for the amount of the judgment plus costs and interest.

Original Judgment          $               

Post Judgment Interest   $               

Costs                              $                      Issued this    (day)    day of                  (month)   ,    (year)   .

Current Amount Owing $                                        (Clerk of the Court)

Solicitor/Agent

(PPR Party Code)                         (Name in Full)                                           

(Street Address)                           (City)             (Province)      (Postal Code)

(Telephone No.)      (Fax No.)      (Call Box)              (Your Reference No.)

To Register Against Serial # Goods at Personal Property Registry, Complete the Following:

Serial No. (Only applicable

to serial no. goods,

e.g. motor vehicles)            (YYYY)        Make and Model            Category
                                                                                                               
                                                                                                               

                                        (Name of Person Authorized                           

(Authorized Signature)      to Complete this form (PRINT))

Form 22

Alberta_black(                             Writ of Enforcement Addendum

                                                                                 Financing Statement

Civil Enforcement Act                                                 (Court File No.)

Debtor

Select one                  Business                  Individual

                                                                                  (Occupation)          

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

(Street Address)                 (City)                     (Province)                                (Postal Code)

Debtor

Select one                  Business                  Individual

                                                                                  (Occupation)          

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

(Street Address)                 (City)                     (Province)                                (Postal Code)

(Debtor’s Block No. (if adding alias))

Creditor

Select one                  Business                  Individual

(Personal

Property Registry

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)                 (City)                     (Province)                                (Postal Code)

Creditor

Select one                  Business                  Individual

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)                 (City)                     (Province)                                (Postal Code)

Additional Information

Form 23

Alberta_black(                                                            Status Report

                                                                    Financing Change Statement

Civil Enforcement Act

                                                                   (Latest PPR Registration No.)

Identification of Registration or Amendments

Current Debtor

(Business Name or Last Name)           (First Name)           (Middle Name)

Current Creditor

(Business Name or Last Name)           (First Name)           (Middle Name)

Type of Registration:       Renewal       Change       Change in Amount

Current Amount Owing            Costs                         Post Judgment Interest

$                                                $                                 $                                 

Deletions

Debtor

Select one                  Business                  Individual

                                                                                                  Birthdate

  (Block No.)                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

Creditor

Select one                  Business                  Individual

(Block No.)    (Business Name or Last Name)    (First Name)    (Middle Name)

Serial Number Goods

(Block No.)       (Serial No.)       (YYYY)       (Make and Model)       (Category)

Additions (if adding as alias, indicate Debtor’s Block No.)

Debtor

Select one                  Business                  Individual

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

                                                                                                 (Debtor’s Block No.)               

(Occupation)                                                                (if adding alias)                        

(Street Address)                 (City)                          (Province)                  (Postal Code)

Creditor

Select one                  Business                  Individual

(Personal

Property Registry

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)             (City)                      (Province)                          (Postal Code)

Serial Number Goods

(Serial No.)          (YYYY)          (Make and Model)                    (Category)

            Total Discharge (This will permanently remove all record of registration(s).)

            Deletion and Additional Debtors, Creditors and/or other information listed on attached addendum.

            Deletion and Addition to Solicitor/Agent listed on attached addendum.

                                          (Name of Person Authorized                         

(Authorized Signature)            to Complete this form (PRINT))

Form 24

Alberta_black(                                        Status Report Addendum

                                                                    Financing Change Statement

Civil Enforcement Act

Deletions

Debtor

Select one                  Business                  Individual

 (Block No.)    (Business Name or Last Name)    (First Name)    (Middle Name)

Creditor

Select one                  Business                  Individual

(Block No.)    (Business Name or Last Name)    (First Name)    (Middle Name)

Serial Number Goods

(Block No.)    (Serial No.)        (YYYY)    (Make and Model)    (Category)

Solicitor/Agent

(Name in Full)                                                                                        

Additions (if adding alias, indicate Debtor’s Block No.)

Debtor

Select one                  Business                  Individual

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

                                                                                                 (Debtor’s Block No.)               

(Occupation)                                                                (if adding alias)                        

(Street Address)                 (City)                          (Province)                  (Postal Code)

Creditor

Select one                  Business                  Individual

(Personal

Property Registry

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)             (City)                      (Province)                          (Postal Code)

Serial Number Goods

(Serial No.)          (YYYY)          (Make and Model)                    (Category)

New Solicitor/Agent

(PPR Party Code)          (Name in Full)                                                                                 

(Street Address)             (City)                      (Province)                    (Postal Code)     

ADDITIONAL INFORMATION

                                                (Name of Person Authorized                   

(Authorized Signature)              to Complete this form (PRINT))

Form 25

Alberta_black(                                                     Attachment Order

                                                                                 Financing Statement

                                              (Court Location)                  Court File No.

This form authorizes enforcement proceedings in accordance with the Civil Enforcement Act.  The particulars of the Attachment Order are as follows:

Defendant

Select one                  Business                  Individual

                                                                  (Occupation)                          

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

(Street Address)                       (City)                              (Province)                 (Postal Code)

Plaintiff

Select one                  Business                  Individual

(Personal

Property Registry

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)             (City)                      (Province)                          (Postal Code)

          Additional Defendants and         Date Attachment Order Granted

          Plaintiffs and/or other                    or date effective (if different)

          information listed on attached                            (dd/mm/yyyy)   

          addendum.                                      Amount of Attachment Order

                                                                                           $                   

Solicitor/Agent

(PPR Party Code)          (Name in Full)                                                   

(Street Address)          (City)                   (Province)                 (Postal Code)

(Telephone No.)              (Fax No.)       (Call Box No.)       (Reference No.)

To Register Against Serial Number Goods at Personal Property Registry (as described in Attachment Order)

Serial Number                     (YYYY)         Make and Mode      Category

(only applicable to serial no.

goods e.g. motor vehicles)

                                                                                                               
                                                                                                               

To Register Against Other Personal Property (as described in the Attachment Order)

                                                                                                               
                                                                                                               

                                                (Name of Person Authorized                   

(Authorized Signature)              to Complete this form (PRINT))

Form 26

Alberta_black(                                Attachment Order Addendum

                                                                                 Financing Statement

                                                                                    (Court File No.)   

Defendant

Select one                  Business                  Individual

                                                                  (Occupation)                          

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

(Street Address)                       (City)                              (Province)                (Postal Code)

(Defendant’s Block No. (if adding alias))

Defendant

Select one                  Business                  Individual

                                                                  (Occupation)                          

                                                                                                  Birthdate

                                                                                               (if known)

(Business Name or Last Name)   (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

(Street Address)                       (City)                              (Province)                (Postal Code)

(Defendant’s Block No. (if adding alias))

Plaintiff

Select one                  Business                  Individual

(Personal

Property Registry

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)             (City)                      (Province)                         (Postal Code)

Plaintiff

Select one                  Business                  Individual

(PPR) Party Code)   (Business Name or Last Name)   (First Name)   (Middle Name)

(Street Address)             (City)                      (Province)                          (Postal Code)

         Additional Information

Form 27

Alberta_black(                                                   Maintenance Order

                                                                                 Financing Statement

                                (Court Location)                 Court File No.

Debtor

     Individual         (Occupation)                                                              

                                                                                                  Birthdate

                                                                                               (if known)

(Last Name )                               (First Name)   (Middle Name)   (Gender M/F)   (dd/mm/yy) 

(Street Address)                       (City)                              (Province)                (Postal Code)

Creditor

        Individual

(Last Name)                            (First Name)                                          (Middle Name)

Date of Order                                             Current Amount      

(or date order effective, if different)                    Owing

     (dd/mm/yy)                                           $                              

Additional Information

Caution:       If your personal address and telephone number are confidential, you are required to provide an address where notices and proceed entitlements can be sent to you.

Creditor/Solicitor/Agent

(Personal

Property Registry

(PPR Party Code)          (Name in Full)                                                   

(Street Address)          (City)                   (Province)                 (Postal Code)

(Telephone No.)              (Fax No.)       (Call Box No.)       (Reference No.)

To Register Against Serial Number Goods at Personal Property Registry, Complete the Following:

Serial Number                     (YYYY)         Make and Mode      Category

(only applicable to serial no.

goods e.g. motor vehicles)

                                                                                                               
                                                                                                               

                                                (Name of Person Authorized                   

(Authorized Signature)              to Complete this form (PRINT))

Form 28

Alberta_black(

                                                                                                                

                                                           Civil Enforcement Agency File Number

Warrant
(Garage Keepers’ Lien Act)

TO:              (Name and address of Civil Enforcement Agency)                  

You are hereby instructed to seize the following vehicle:

Make                                                         Model                                    

Serial number                                            License number                     

the property of             (Name and Address of Owner)                          

now in the possession of    (Name and address of party in possession  .  This vehicle is subject to a garage keeper’s lien registered in the Personal Property Registry on the    (day)    day of    (month)  ,    (year)    as Registration Number                  .  Seizure is instructed to realize the sum of $          plus costs claimed by    (Name of Creditor)    for:

(Please indicate with an X the reason for the claim.)

          storage of motor vehicle or farm vehicle or a part of a motor vehicle or a farm vehicle

          repair of a motor vehicle or farm vehicle or a part of a motor vehicle or farm vehicle

          maintenance of a motor vehicle or farm vehicle or a part of a motor vehicle or a farm vehicle

          price of accessories or parts furnished for a motor vehicle or farm vehicle or a part of a motor vehicle or a farm vehicle

          possession of the motor vehicle or farm vehicle was surrendered to the owner or the owner’s agent on                                                                                        

          repairs were completed to the motor vehicle, farm vehicle or part of a motor vehicle or farm vehicle where the vehicle was not at the time of repair in the possession of the garage keeper on  

          accessories or parts were furnished to the motor vehicle or farm vehicle on  

Dated this    (day)    day of    (month)  ,    (year)    at      (city)       , Alberta

                                              (Signature of Instructing Garage Keeper or

                                                                                 Authorized Agent)  

        (Print Name of Instructing Garage Keeper or Authorized Agent)    

        (Address of Instructing Garage Keeper or Authorized Agent)         

          (City)          ,           (Province)                         (Postal Code)              

          (Telephone Number)                                        (Fax number)       

AR 231/2002 Sched.;35/2007;230/2007