Foreign Ownership of Land Regulations (SOR/79-416)

I (We)

of (full address including street, municipality and country.)

SOLEMNLY DECLARE THAT:

• 1 

  I (We) am (are) the transferee(s), transmittee(s), caveator(s) or lessee(s) named in the above described instrument and will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and I (we) am (are) a Canadian citizen(s).

  or

  I (We) am (are) the transferee(s), transmittee(s), caveator(s) or lessee(s) named in the above described instrument and will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and I (we) am (are) a permanent resident(s) within the meaning of the Immigration Act, 1976 (Canada).

  Date Landed: , Port of Entry: ,

  Birth Date: , and my (our) previous country of

  permanent residency was: .

  or

  I am a member of the Law Society of Alberta and am the solicitor for the transferee(s), transmittee(s), caveator(s) or lessee(s) named in the above described instrument who will hold the interest in the land beneficially and not as trustee(s) and not on behalf of any person and who is (are) a Canadian citizen(s) or permanent resident(s) within the meaning of the Immigration Act, 1976 (Canada).

  Date Landed: , Port of Entry: ,

  Birth Date: , and his (her or their) previous country of

  permanent residency was: .

• 2 

  The true consideration paid or payable in respect of the transactionFootnote ^* is as follows:

  (give full details of purchase or rental as applicable, including total price paid)

• 3 

  The present value of the landFootnote ^*, in my opinion, is $  

  (“land includes buildings and other improvements affixed to the land”)

  • Return to footnote ^*Answer required only for transmissions, caveats and leases.

AND I (WE) 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.

(SEVERALLY) DECLARED before me

CONSENT OF PERMANENT RESIDENT(S)

I (We), being a permanent resident(s), give my (our) consent to the Department of Employment and Immigration (Canada) to disclose information concerning my (our) status in Canada to the Minister or someone authorized by him.