Personal Property Security Forms Regulation (Alta. Reg. 50/2021)

Alta. Reg. 50/2021

Alberta — Regulations

© Published by Alberta King’s Printer Alberta King’s Printer Suite 700, Park Plaza 10611 - 98 Avenue Edmonton, AB T5K 2P7 Phone: 780-427-4952 E-mail: kings-printer@gov.ab.ca Shop on-line at kings-printer.alberta.ca Province of Alberta Office Consolidation Alberta Regulation 50/2021 With amendments up to and including Alberta Regulation 73/2023 Current to June 1, 2024 PERSONAL PROPERTY SECURITY ACT PERSONAL PROPERTY SECURITY FORMS REGULATION

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Note All persons making use of this consolidation are reminded that it has no legislative sanction, that amendments have been embodied for convenience of reference only. The official Statutes and Regulations should be consulted for all purposes of interpreting and applying the law.

(Consolidated up to 73/2023) ALBERTA REGULATION 50/2021 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 Repeal 2 The Personal Property Security Forms Regulation (AR 231/2002) is repealed.

Schedule Form 1 PPSA Security Agreement, Sale of Goods Act

section 26(2) or Factors Act

section 9(2) 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 Select one □ Business □ Individual Birthdate (if known) (Business Name or Last Name) (First Name) (Middle Name) (dd/mm/yy)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 2 (Street Address) (City) (Province) (Postal Code) Debtor 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) (Email Address) 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 2 Writ of Seizure and Sale (Federal Writ) Civil Enforcement Act 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:

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 3 Debtor Select one □ Business □ Individual (Occupation) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) Gender □ M □ F (Birthdate if known (yyyy-mm-dd)) Creditor Select one □ Business □ Individual Personal Property Registry (P.P.R.) Party Code (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) □ Additional Debtors, 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 $ Solicitor/Agent Personal Property Registry (P.P.R.) Party Code (Name in Full) (Street Address) (City) (Province) (Postal Code) (Email Address) (Telephone Number) (Fax Number) (Call Box Number) (Reference Number) To Register Against Serial Number Goods at Personal Property Registry, Complete the Following: Serial Number (Only applicable to serial number goods, e.g. motor vehicles) (YYYY) Make and Model Category ___________________________________________ _____________________ Name of Person Authorized to Complete Form (print) Authorized Signature

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 4 Form 3 Writ of Seizure and Sale (Federal Writ) Civil Enforcement Act Financing Statement Addendum (Write file number) ________ Debtor Select one □ Business □ Individual (Occupation) (Business Name or Last Name) (First Name) (Middle Name) Gender □ M □ F (Birthdate if known (yyyy-mm-dd)) (Street Address) (City) (Province) (Postal Code) Debtor Select one □ Business □ Individual (Occupation) (Business Name or Last Name) (First Name) (Middle Name) Gender □ M □ F (Birthdate if known (yyyy-mm-dd)) (Street Address) (City) (Province) (Postal Code) Creditor Select one □ Business □ Individual Personal Property Registry (P.P.R.) Party Code (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Solicitor/Agent Personal Property Registry (P.P.R.) Party Code (Name in Full) (Street Address) (City) (Province) (Postal Code) (Email Address) (Telephone Number) (Fax Number) (Call Box Number) (Reference Number)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 5 Collateral — Serial Number Goods Serial Number (YYYY) Make and Model Category Additional Information ___________________________________________ _____________________ Name of Person Authorized to Complete Form (print) Authorized Signature Form 4 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) □ Family 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) (Email Address) Solicitor/Agent (If Court Order or Receiver’s Report)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 6 Personal Property Registry (P.P.R.) Party Code (Name in Full) (Street Address) (City) (Province) (Postal Code) (Email Address) Collateral – Serial Number Goods Serial Number (YYYY) Make and Model Category General Collateral (If Court Order, Family 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 5 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

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 7 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) (Email Address) Secured Party Select one □ Business □ Individual (Secured Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) 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) (Email Address) (Telephone Number) (Fax Number) (Call Box Number) (Reference Number) Form 6 Serial Number Goods Additions Collateral – Serial Number Goods (If PPSA, applicable only to consumer goods or equipment) Serial Number (YYYY) Make and Model Category

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 8 Form 7 General Collateral Additions General Collateral – Description Form 8 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

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 9 Form 9 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 Number) (YYYY) (Make and Model) (Category) NOTE: To DELETE other collateral, complete and attach: Form 11 – Collateral Deletions. Additions Debtor Select one □ Business □ Individual

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 10 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) (Email Address) 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 6 – Serial Number Goods Additions, and/or Form 7 – General Co llateral Additions. (Your Reference No.) (Name of Person Authorized (Phone (Call Box (Authorized Signature) to Complete this Form (PRINT)) No.) No.) Form 10 Debtor/Secured Party or Solicitor/Agent Deletions Debtor (Block Number) (Business Name or Last Name) (First Name) (Middle Name) Secured Party/Solicitor/Agent (Block Number) (Business Name or Last Name) (First Name) (Middle Name)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 11 Form 11 Collateral Deletions Serial Number Goods Block No. Serial Number (YYYY) Make and Model Category General Collateral Block No. Description Form 12 Garage Keepers’ Lien Financing Statement Registration Details NOTE: In these questions, the w ords “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 premise s, 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

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 12 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) (Email Address) Describe Motor Vehicle, Farm Vehicle, Aircraft or Boat (Serial Number) (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 13 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) (Email Address) 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 C ourt Order? (dd/mm/yy)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 13 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 14 Global Financing Change Statement Current Secured Party/Solicitor/Agent/Civil Enforcement Agent Information (Current Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) Distribution Method — Select one □ Mail □ Call Box (Number) □ Email (Address) □ Print □ Fax (Number) Complete either A or B below: A.

Change of Name or Address for: □Current Secured Party □Current Solicitor/Agent □Current Civil Enforcement Agent Select one □ Business □ Individual (New Business Name or Last Name) (First Name) (Middle Name) (New Street Address) (City) (Province) (Postal Code) (Email Address) B. Change of Party Code for: □ Secured Party □ Solicitor/Agent □ Civil Enforcement Agent Select one □ Business □ Individual

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 14 (New Party Code) (New Business Name or Last Name) (First Name) (Middle Name) (New Street Address) (City) (Province) (Postal Code) (Email Address) Transmitting Party Select one □ Business □ Individual (Secured Party Code) (New Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) (Your Reference Number) (Authorized Signature) (Name of Person Authorized to Complete This Form (PRINT)) (Telephone Number) (Call Box Number) Form 15 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 □ Email (Call Box Number) (Fax Number) (Email Address) Registration Number(s) (Your Reference No.) (Name of Person Authorized (Phone (Call Box (Authorized Signature) to Complete this Form (PRINT)) No.) No.)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 15 Form 16 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 □ Email (Call Box Number) (Fax Number) (Email 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) (Ma ke and Model) (Category) 2 (Serial Number) (YYYY) (Ma ke and Model) (Category) Registration Number(

s) Search 1 2

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 16 (Your Reference No.) (Name of Person Authorized (Phone (Call Box (Authorized Signature) to Complete this Form (PRINT)) No.) No.) Form 17 Demand to Secured Party Personal Property Security Act

Section 50 To: (Name of Secured Party) 1. A Financing Statement was r egistered 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 Ch ange Statement for the purpose of (Describe type of chang e 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 Fi nancing 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)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 17 Form 18 Proof of Demand to Secured Party Personal Property Security Act

Section 50 Statutory Declaration I, of (Address) in the Province of , (Postal Code) , DO SOLEMNLY DECLARE THAT: 1. A Financing Statement was reg istered 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 co py of the Demand to Secured Party that 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.

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 18 Declared before me ) at the of ) in the province of ) (Signature) on (day) day of (month) , (year) . ) Form 19 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 on 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

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 19 Form 20 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 instr ument 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 21 Affidavit Verifying Notice Personal Property Security Regulation

Section 66(1) I, of in the Province of , (postal code) , make oath (affirm) 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.

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 20 2. That I have full knowledge of the facts set out in the attached notice and the statement of facts is true. Sworn (affirmed) before me, , ) this (day) day of (month) , (year) ) (Signature of agent) at , Alberta. ) Form 22 Affidavit Verifying Notice (Video Conferencing) Personal Property Security Regulation

Section 66(1) I, of in the Province of , (postal code) , make oath (affirm) 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. 3. That I am executing this docum ent by two-way video conferencing separate and apart from any other person.

Sworn (affirmed) 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 ) (A gent) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer) Form 23 Demand to Secured Party (Fixtures or Crops) Personal Property Security Act

Section 49 To: (Name of Secured Party)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 21 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 d ebtor 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 nee d not be amended or discharged. 4. If this demand is not complied with, I intend to submit a Ch ange 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 24 Proof of Demand to Secured Party (Fixtures or Crops) Personal Property Security Act

Section 49 Statutory Declaration I, of (Address) in the Province of , (postal code) , DO SOLEMNLY DECLARE THAT:

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 22 1. A Notice of Security Interest was registered in the Land Titles Office as instrument number against the following land: (Give legal de scription and LINC if known) 2. I am named as the d ebtor 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 co py of the Demand to Secured Party that 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 25 Proof of Demand to Secured Party (Fixtures or Crops) (Video Conferencing) Personal Property Security Act

Section 49 Statutory Declaration I, of (Address) in the Province of , (postal code) ,

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 23 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 d ebtor 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 th e (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. 7. I am executing this document by two-way video conferencing separate and apart from any other person. 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, , ) 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 ) (Depone nt) deponent’s identity and confirm the contents ) of the document being executed. ) (Lawyer)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 24 Form 26 Filed Writ of Enforcement Financing Statement Civil Enforcement Act 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 (P.P.R.) Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Additional Debt ors and Creditors and/or other information listed on attached addendum. If claiming priority based on an Attachment Order or

part ial Assignment, indicate previous P.P.R. 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 $

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 25 Post Judgment Interest $ Costs $ Issued this (day) day of (month) , (year) . Current Amount Owing $ (Clerk of the Court) Solicitor/Agent (P.P.R.

Party Code) (Name in Full) (Street Address) (City) (Province) (Postal Code) (Telephone Number) (Fax Number) (Email Address) (Call Box) (Reference Number) To Register Against Serial Number Goods at Personal Property Registry, Complete the Following: Serial Number (Only applicable to serial number goods, e.g. motor vehicles) (YYYY) Make and Model Category (Name of Person Authorized (Authorized Signature) to Complete this Form (PRINT)) Form 27 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)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 26 (Debtor’s Block No. (if adding alias)) Creditor Select one □ Business □ Individual (Personal Property Registry (P.P.R.) Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Creditor Select one □ Business □ Individual (P.P.R. Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Additional Information Form 28 Status Report Financing Change Statement Civil Enforcement Act (Latest P.P.R.

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

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 27 Select one Business Individual Birthdate (if known) (Block No.) (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 Number) (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 (P.P.R.) Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Serial Number Goods (Serial Number) (YYYY) (Make and Model) (Category) Total Discharge (This will permanently remove all record of registration(s).) Deletion and Ad ditional Debtors, Creditors and/or other information listed on attached addendum.

Deletion and Addition to Solicitor/Agent listed on attac hed addendum.

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 28 (Name of Person Authorized (Authorized Signature) to Complete this Form (PRINT)) Form 29 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 Number) (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 (P.P.R.) Party Code) (Business Name or Last Name)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 29 (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Serial Number Goods (Serial Number) (YYYY) (Make and Model) (Category) New Solicitor/Agent (P.P.R. Party Code) (Name in Full) (Street Address) (City) (Province) (Postal Code) (Email Address) ADDITIONAL INFORMATION (Name of Person Authorized (Authorized Signature) to Complete this Form (PRINT)) Form 30 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 (P.P.R.) Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 30 Additional Defendants and Date Attachment Order Granted Plaintiffs and/or other or date effective (if different) information listed on attached (yyyy/mm/dd) addendum. Amount of Attachment Order $ Solicitor/Agent (P.P.R.

Party Code) (Name in Full) (Street Address) (City) (Province) (Postal Code) (Email Address) (Telephone Number) (Fax Number) (Call Box Number) (Reference Number) To Register Against Serial Number Goods at Personal Property Registry (as described in Attachment Order) Serial Number (YYYY) Mak e and Mode Category (only applicable to serial number 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 31 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

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 31 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 (P.P.R.) Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Plaintiff Select one □ Business □ Individual (P.P.R.

Party Code) (Business Name or Last Name) (First Name) (Middle Name) (Street Address) (City) (Province) (Postal Code) (Email Address) Additional Information Form 32 Maintenance Order Financing Statement (Court Location) Court File No. Debtor Individual (Occupation)

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 32 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) (Email Address) Date of Order Curre nt 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 (P.P.R.) Party Code) (Name in Full) (Street Address) (City) (Province) (Postal Code) (Email Address) (Telephone Number) (Fax Number) (Call Box Number) (Reference Number) To Register Against Serial Number Goods at Personal Property Registry, Complete the Following: Serial Number (YYYY) Mak e and Mode Category (only applicable to serial number goods, e.g. motor vehicles) (Name of Person Authorized (Authorized Signature) to Complete this Form (PRINT))

Schedule AR 50/2021 PERSONAL PROPERTY SECURITY FORMS REGULATION 33 Form 33 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 (indicate with an X the reason for the claim): storage of motor vehicle or farm vehicle or a part of a m otor 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 pa rts 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 surre ndered 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 50/2021 Sched;73/2023

Printed on Recycled Paper *9780779843602*

Document details

Collection	Alberta — Regulations
Citation	Alta. Reg. 50/2021
Type	regulation
Volume / chapter	2021 050
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	ced67d1b8f7f47b81b84a7090ad59bdbb81eaa99

Source file is stored in the law ingest library (pdf).