Transmission to Surviving Joint Tenant – Fee Simple · Joint Tenant – Fee Simple If there is...
Transcript of Transmission to Surviving Joint Tenant – Fee Simple · Joint Tenant – Fee Simple If there is...
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For more information, contact the Customer Service Centre at 604-630-9630 in the Greater Vancouver area or 1-877-577-LTSA (5872) toll free elsewhere in BC, or visit www.ltsa.ca.
Instructions:Please type or print clearly in dark ink on all forms. Kindly print your documents on single-side paper only to facilitate departmental processing. Please mail or courier your application in hard copy format to the New Westminster office. Fax or email applications will not be accepted.
1. Provide an Original Death Certificate from the Vital Statistics Agency.
a. Do not send a funeral director’s certificate, photocopy or notarized copy.
b. You may obtain documents for deaths that occurred in BC from BC’s Vital Statistics Agency (call 250-952-2681 or toll free at 1-888-876-1633) or the nearest Service BC office.
2. If the certificate is not written in English, provide an English translation. The translation should be done by an official translator or by someone fluent in both English and the original language used on the certificate.
a. Include a statutory declaration completed by the translator, confirming the translation is accurate and true.
b. The translated certificate and the statutory declaration will be kept by the Registrar and will not be returned to you.
3. If the name on the death certificate is not exactly as shown on the title, you may be required to provide additional documentation proving identity.
4. Complete Form 17.
5. Provide the existing Duplicate Indefeasible Title Certificate, if not on file with the Land Title Office.
6. Complete the Property Transfer Tax Return.
a. The form can be filled out online.
b. If filling out online, print, sign and enclose the completed form.
This is a guide to help you prepare your application. It is important to be aware that legislation defines the LTSA’s role and limits how we can answer your questions. For example, our staff is not allowed to provide legal advice or help fill out forms.
Only after you submit your application to the LTSA, can we advise on the correctness and accuracy of your application’s information.
If you need more help than we can provide, please contact a legal professional.
Transmission to Surviving Joint Tenant – Fee Simple
If there is any doubt about the authenticity or acceptability of a certificate, it may be held for review by the Land Title Office. In general, if the certificate has been issued by an authorized public officer and is written in English or includes an English translation on the certificate itself, the certificate is an acceptable form of evidence.
To confirm the exact name(s) on the title, consider registering for a myLTSA Explorer account and doing a title search.
http://www.ltsa.cahttps://www2.gov.bc.ca/assets/gov/taxes/property-taxes/property-transfer-tax/forms-publications/fin-544-surviving-joint-tenant-manual-ptt-return.pdfhttps://apps.ltsa.ca/iam/signup
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For more information, contact the Customer Service Centre at 604-630-9630 in the Greater Vancouver area or 1-877-577-LTSA (5872) toll free elsewhere in BC, or visit www.ltsa.ca.
c. For assistance with this form, contact the Ministry of Finance, Property Transfer Tax Section, at 250-387-0555 or toll free at 1-888-355-2700.
7. Complete the Transparency Declaration for the Land Owner Transparency Registry.
8. If the transferee is a Reporting Body, complete the Transparency Report for the Land Owner Transparency Registry.
9. Confirm if your application qualifies for an Exclusion from the Land Owner Transparency Registry. In limited circumstances, exclusions to LOTR may apply. Refer to the Declaration of Exclusion form to confirm if your application qualifies for an exclusion and, if required, complete the Declaration of Exclusion form. If the exclusion applies, do not complete the Transparency Report OR Transparency Declaration forms.
10. If you require confirmation of registration, please complete the Request for State of Title Certificate.
11. Submit your application by mail to: Land Title and Survey Authority of British Columbia Suite 500 – 11 Eighth Street, New Westminster, BC V3M 3N7
Fees1. Pay the registration fee of $75.22 for each parcel being transmitted.2. Pay the filing fee of $5.00 for the Transparency Declaration.3. If a Transparency Report is required, pay the filing fee of $35.00.4. If you have requested a State of Title Certificate, pay $15.04 for
each title.
For more information Email: [email protected]
Phone: 604-630-9630 from the Greater Vancouver area OR 1-877-577-LTSA (5872) from elsewhere in BC, Canada and the US. Office hours are 9:00am to 3:00pm
Mail: Land Title and Survey Authority of British Columbia Suite 500 – 11 Eighth Street, New Westminster, BC V3M 3N7
The Land Owner Transparency RegistryBeginning November 30, 2020, the Land Owner Transparency Act (LOTA) requires that when an application is made to register an interest in land, as defined in LOTA, in BC’s land title register, a transparency declaration must be filed to the LOTA Administrator by the transferee(s). A transferee that is a reporting body must also complete and file a transparency report setting out information about the reporting body and interest holders. We recommend you consult a legal professional to understand your obligations. More information is available at landtransparency.ca
Please include payment by cheque or money order in Canadian funds.
To cover LTSA application registration fees, please make cheque or money order payable to “LTSA of BC”.
Please only complete the Declaration of Exclusion form if you are filing an application to register an interest in land that is excluded from the requirements of LOTA. If the interest in land is not excluded under LOTA, you must file a transparency declaration and if also required, a transparency report. For further information, visit https://landtransparency.ca
http://www.ltsa.camailto:customerservice%40ltsa.ca?subject=http://landtransparency.cahttps://landtransparency.ca
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For more information, contact the Customer Service Centre at 604-630-9630 in the Greater Vancouver area or 1-877-577-LTSA (5872) toll free elsewhere in BC, or visit www.ltsa.ca.
Before you submit your application, ensure you have the following:
Original Death Certificate from the Vital Statistics Agency.
If the certificate is not written in English, an English translation.
If the name on the death certificate is not exactly as shown on the title, you may be required to provide additional documentation proving identity.
Completed Form 17.
Existing Duplicate Indefeasible Title Certificate, if not on file with the Land Title Office.
Completed Property Transfer Tax Return.
• If filling out online, print, sign and enclose the completed form.
Completed Transparency Declaration.
Completed Transparency Report, if required.
Registration fee of $75.22 for each parcel being transmitted.
Filing fee of $5.00 for the Transparency Declaration.
If a Transparency Report is required, filing fee of $35.00.
Request for State of Title Certificate form (if you require confirmation of registration) and payment of $15.04 for each title.
Checklist
http://www.ltsa.ca
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For more information, contact the Customer Service Centre at 604-630-9630 in the Greater Vancouver area or 1-877-577-LTSA (5872) toll free elsewhere in BC, or visit www.ltsa.ca.
Registration ProcessWhat happens when you submit your land title documents to the LTSA?
Identification of DocumentationTo identify your documents, the cashier will stamp your document with the date, time and a pending application number.
Recourse for ApplicantsIf you receive a Defect Notice, please be aware of the stated time limits for resubmission. If the requirements are not met within the time indicated, your application may be cancelled.
Unsuccessful RegistrationIf your application does not meet basic Land Title Act requirements, a Notice Declining to Register (Defect Notice) will be mailed to the address in Item 1 of your application. This Defect Notice will describe the reason for the defect and may suggest what is needed to meet the requirements of the appropriate Land Title Act or related statutes. An additional fee of up to $15.04 may be required when you return your documents to the Land Title Office.
Successful RegistrationIf your document meets the basic requirements of the Land Title Act and related statutes, it will be registered and recorded with the application number effective on the date and time originally stamped on your document. If you would like confirmation of registration, you may order a State of Title Certificate using the enclosed form.
http://www.ltsa.ca
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Land Title Act Form 17 (sections 154, 155(1), 241)
Applicant: (full name, address, phone number and signature of applicant, applicant’s solicitor or agent)
................................................................................ Signature of applicant or solicitor or authorized agent
Parcel Identifier(s) and Legal Description(s) of Land:
Market Value: $ (applicable to fee simple applications)
Nature of Interest: Transmission to Surviving Joint Tenant
Registration Number of Charge, Notation or Filing: (applicable to modification or cancellation of a registered interest)
Full Name, Address and Occupation of Person(s) Entitled to be Registered Owner: (not applicable to a cancellation of charge, notation or filing)
NOTE: Before submitting this application, applicants should check and satisfy themselves as to the tax position, including taxes of the Crown Provincial, a municipality and improvement, water
and irrigation districts.
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Land Title and Survey Authority of British Columbia State of Title Certificate Request Form
This form is for the order of a State of Title Certificate in paper format.
Fee: $15.04 per State of Title Certificate payable to the Land Title and Survey Authority of British Columbia
State of Title Certificate is required for the following lands: (Insert Parcel Identifier number (PID) and Legal Description here)
Applicant Name:
Mailing Address:
OPTIONAL
Related application number:
Agent:
LTO Client Number:
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1 of 3 PagesTransparency declaration© Copyright 2021, Land Title and Survey Authority of British Columbia. All rights reserved.
Transparency Declaration
2. Transferee Information
Reporting body type (select one)If yes:
Is this transferee a reporting body?
Corporation
Individual
PID(s)
Type
1. Property Information
Transferee 1
Last name Given name(s)
Relevant corporation
Yes
Trustee of a relevant trust Partner of a relevant partnership
No
Reporting body is exempt from the requirement to file a Transparency Report under s. 21 of the Land Owner Transparency Regulation
Enter the Parcel Identifier (PID) assigned to the land being transferred.
Name of corporation
(select one)
Land title or charge number Legal description of land
*If the parcel has not been assigned a PID, enter another identifier or a legal description of the parcel below. Titles and charges that do not have a PID are those recorded in an Absolute Fee Book (AFB), Indefeasible Fee Book (IFB), Absolute Fee Charge Book (AFCB) or are Vancouver Street Leases.
Suggested structure of title or charge entry: //
Examples of legal description of a parcel of land: District Lot 1234, Cariboo Land DistrictLot 1, District Lot 555, New Westminster District, Plan 12345
*If more space is needed, enter the remaining PIDs in another Transparency Declaration form.
Examples of titles / charges: NW AFB 18/155/979a KA AFCB 1/524/1960 VA IFB 6/447/17185
This information is collected by the Land Title and Survey Authority of British Columbia under s. 26(a) and s. 26(c) of the Freedom of Information and Protection of Privacy Act and will be used for general administration of the Land Owner Transparency Act and its regulations. Should you have any questions about the collection of this personal information please contact:
Administrator, Land Owner Transparency ActLand Title and Survey Authority of British ColumbiaSuite 500 – 11 Eighth Street, New Westminster, BC V3M 3N7T: 1-877-577-5872 or 604-630-9630 E: [email protected]
Does the land being transferred have a Parcel Identifier (PID) assigned to it? Yes No*If yes:
If no: Enter another identifier or a legal description of the parcel. (Select one)
mailto:lotr%40ltsa.ca?subject=
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2 of 3 PagesTransparency declaration© Copyright 2021, Land Title and Survey Authority of British Columbia. All rights reserved.
Transparency Declaration
Reporting body type (select one)
Reporting body type (select one)
Reporting body type (select one)
If yes:
If yes:
If yes:
Is this transferee a reporting body?
Is this transferee a reporting body?
Is this transferee a reporting body?
Relevant corporation
Relevant corporation
Relevant corporation
Yes
Yes
Yes
Trustee of a relevant trust
Trustee of a relevant trust
Trustee of a relevant trust
Partner of a relevant partnership
Partner of a relevant partnership
Partner of a relevant partnership
No
No
No
Corporation
Corporation
Corporation
Individual
Individual
Individual
Type
Type
Type
Transferee 2
Transferee 3
Transferee 4
Last name
Last name
Last name
Given name(s)
Given name(s)
Given name(s)
Name of corporation
Name of corporation
Name of corporation
(select one)
(select one)
(select one)
Reporting body is exempt from the requirement to file a Transparency Report under s. 21 of the Land Owner Transparency Regulation
Reporting body is exempt from the requirement to file a Transparency Report under s. 21 of the Land Owner Transparency Regulation
Reporting body is exempt from the requirement to file a Transparency Report under s. 21 of the Land Owner Transparency Regulation
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3 of 3 PagesTransparency declaration© Copyright 2021, Land Title and Survey Authority of British Columbia. All rights reserved.
Transparency Declaration
Certification date (YYYY-MM-DD)Signature
Certifier 4 - Name (Printed) Certifying on behalf of the following transferee
Certification date (YYYY-MM-DD)Signature
Certifier 3 - Name (Printed) Certifying on behalf of the following transferee
Certification date (YYYY-MM-DD)Signature
Certifier 2 - Name (Printed) Certifying on behalf of the following transferee
Certification date (YYYY-MM-DD)Signature
Certifier 1 - Name (Printed) Certifying on behalf of the following transferee
I, having knowledge of the matters included in this transparency declaration and having the actual authority to certify this declaration as the transferee or on behalf of the transferee, I certify that this transparency declaration is correct and complete to the extent required under s. 10(3) and s. 25 of the Land Owner Transparency Act (LOTA). I understand and acknowledge that LOTA provides for administrative penalties under Division 4 of Part 4 and for fines and other monetary payments under Part 6 for the provision of false or misleading information in a transparency declaration.
3. Certifier Information
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PID(s)
Land title or charge number Legal description of land
If the parcel has not been assigned a PID, enter another identifier or a legal description of the parcel below. Titles and charges that do not have a PID are those recorded in an Absolute Fee Book (AFB), Indefeasible Fee Book (IFB), Absolute Fee Charge Book (AFCB) or are Vancouver Street Leases.
*If more space is needed, enter the remaining PIDs in another Transparency Report form.
Transparency Report
1 of 23 PagesTransparency Report© Copyright 2020, Land Title and Survey Authority of British Columbia. All rights reserved.
2. Reporting Body - Primary Identification
Transparency Report ID # of previously filed report:
1. Property Information
This information is collected by the Land Title and Survey Authority of British Columbia under s. 26(a) and s. 26(c) of the Freedom of Information and Protection of Privacy Act and will be used for general administration of the Land Owner Transparency Act and its regulations. Should you have any questions about the collection of this personal information please contact:
Administrator, Land Owner Transparency ActLand Title and Survey Authority of British ColumbiaSuite 500 – 11 Eighth Street, New Westminster, BC V3M 3N7T: 1-877-577-5872 or 604-630-9630 E: [email protected]
If yes:
Is this Transparency Report being filed to update or correct a previously filed Transparency Report? Yes
Corporation
Corporation
No
Individual
Individual
Relevant corporation
Go to Section 2.1
Go to Section 2.1
Go to Section 2.2
Go to Section 2.2
The trustee is a(n):
The partner of the relevant partnership is a(n):
Trustee of a relevant trust
Partner of a relevant partnership
The reporting body is a:
Go to Section 2.1
2.1. Corporation
Name of corporation
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Registered Office Address
Suggested structure of title or charge entry: //
Examples of legal description of a parcel of land: District Lot 1234, Cariboo Land DistrictLot 1, District Lot 555, New Westminster District, Plan 12345
Examples of titles / charges: NW AFB 18/155/979a KA AFCB 1/524/1960 VA IFB 6/447/17185
Enter the Parcel Identifier (PID) assigned to the land being transferred.
mailto:lotr%40ltsa.ca?subject=
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Transparency Report
2 of 23 PagesTransparency Report© Copyright 2020, Land Title and Survey Authority of British Columbia. All rights reserved.
2.2. Individual
2.3. Relevant Partnership
Jurisdiction of Incorporation
If the corporation or company has been continued or transferred into another jurisdiction, the jurisdiction into which the corporation or company was most recently continued or transferred (if applicable)
Last name Given name(s)
City Province
City Country
Is the individual a Canadian citizen or permanent resident of Canada within the meaning of the Immigration and Refugee Protection Act (Canada)?
Is the individual’s principal residence in Canada?
Yes
Yes
No
NoIf yes:
If no:
Countries or states of citizenshipIf no:
If the reporting body is a:
If the reporting body is a:
Go to Section 3.1Relevant corporation
Go to Section 3.2Trustee of a relevant trust
Go to Section 3.2Trustee of a relevant trust
Go to Section 2.3Partner of a relevant partnership
Go to Section 2.3Partner of a relevant partnership
Partnership’s registered business name (if applicable)
Partnership type (select one)
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Head Office Address
Does the corporation have a head office? Yes No If yes, enter Head Office Address.
The head office address is the same as above
General partnershipLimited partnershipLimited liability partnershipProfessional partnership
Foreign partnership within the meaning of the Partnership ActSimilar legal relationship created in another jurisdictionOther partnership type (specify)
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Transparency Report
3 of 23 PagesTransparency Report© Copyright 2020, Land Title and Survey Authority of British Columbia. All rights reserved.
The partnership’s principal business premises is the same address as above
Address 1 (Street No./Name
City
Jurisdiction, the laws of which govern the partnership or the partnership agreement
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Address of the Partnership’s Principal Business Premises
Go to Section 3.3
Go to Section 3.2.1.1 Go to Section 3.2.1.2
3. Reporting Body - Additional information
3.1. Relevant corporation
3.2. Trustee of a relevant trust
Incorporation number (or continuation, amalgamation, or other identifying number or designation)
Business number, if any, within the meaning of the Income Tax Act (Canada)
Reference number of the trust instrument (if applicable)
Settlor(s) of the Trust
3.2.1. Settlor 1
3.2.1.1. Settlor 1 - Corporation - Primary Identification
Type (select one) Corporation Individual
Name of Corporation
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Registered Office Address
Does the corporation have a head office? Yes No If yes, enter Head Office Address.
Go to Section 4
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Registered Office Address or Head Office Address
Go to Section 4Go to Section 3.2.1Are there any settlors of the trust? Yes No
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Transparency Report
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If the corporation or company has been continued or transferred into another jurisdiction, the jurisdiction into which the corporation or company was most recently continued or transferred (if applicable)
Was the reporting body able to obtain and confirm the accuracy of all required information about the settlor?
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the settlor?
Yes
Yes
No
No
For the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
Describe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the settlor.
If no:
If no:
3.2.1.2. Settlor 1 - Individual
3.2.1.2.1. Settlor 1 - Primary IdentificationLast name Given name(s)
City Province
City Country
Is the individual a Canadian citizen or permanent resident of Canada within the meaning of the Immigration and Refugee Protection Act (Canada)?
Is the individual’s principal residence in Canada?
Yes
Yes
No
NoIf yes:
If no:
Countries or states of citizenshipIf no:
Go to Section 4
Jurisdiction of Incorporation
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Head Office Address The head office address is the same as above
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Transparency Report
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Last Known Address
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Is the individual resident in Canada for the purposes of the Income Tax Act (Canada)? Yes No
Was the reporting body able to obtain and confirm the accuracy of all required information about the settlor? Yes NoFor the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
If no:
Has a determination of incapacity been made in respect of this individual? Yes No
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the settlor? Yes NoDescribe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the settlor.If no:
Go to Section 4
Go to Section 3.2.2.1 Go to Section 3.2.2.2
3.2.2. Settlor 2
3.2.2.1. Settlor 2 - Corporation - Primary Identification
Type (select one) Corporation Individual
Name of Corporation
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Registered Office Address
Does the corporation have a head office? Yes No If yes, enter Head Office Address.
3.2.1.2.2. Settlor 1 - Additional InformationDate of birth (YYYY-MM-DD) Social insurance number Individual tax number
Individual does not have a SIN Individual does not have an ITN
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Transparency Report
6 of 23 PagesTransparency Report© Copyright 2020, Land Title and Survey Authority of British Columbia. All rights reserved.
Jurisdiction of Incorporation
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Head Office Address The head office address is the same as above
If the corporation or company has been continued or transferred into another jurisdiction, the jurisdiction into which the corporation or company was most recently continued or transferred (if applicable)
Was the reporting body able to obtain and confirm the accuracy of all required information about the settlor?
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the settlor?
Yes
Yes
No
No
For the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
Describe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the settlor.
If no:
If no:
Go to Section 4
3.2.2.2. Settlor 2 - Individual
3.2.2.2.1. Settlor 2 - Primary IdentificationLast name Given name(s)
City Province
City Country
Is the individual a Canadian citizen or permanent resident of Canada within the meaning of the Immigration and Refugee Protection Act (Canada)?
Is the individual’s principal residence in Canada?
Yes
Yes
No
NoIf yes:
If no:
Countries or states of citizenshipIf no:
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Transparency Report
7 of 23 PagesTransparency Report© Copyright 2020, Land Title and Survey Authority of British Columbia. All rights reserved.
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Last Known Address
Is the individual resident in Canada for the purposes of the Income Tax Act (Canada)?
Has a determination of incapacity been made in respect of this individual?
Yes
Yes
No
No
3.2.2.2.2. Settlor 2 - Additional InformationDate of birth (YYYY-MM-DD) Social insurance number Individual tax number
Individual does not have a SIN Individual does not have an ITN
Was the reporting body able to obtain and confirm the accuracy of all required information about the settlor?
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the settlor?
Yes
Yes
No
No
For the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
Describe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the settlor.
If no:
If no:
Go to Section 4
3.3. Partner of a relevant partnership
Identifying number, if any, issued to partnershipPartnership’s business number, if any, within the meaning of the Income Tax Act (Canada)
Go to Section 4
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Transparency Report
8 of 23 PagesTransparency Report© Copyright 2020, Land Title and Survey Authority of British Columbia. All rights reserved.
Are there any individuals who are interest holders of the relevant corporation, partnership or trust?4. Interest Holder(s)
Yes NoProvide a statement required under s. 21 of LOTA.If no:
If yes:
4.1. Interest Holder 1
4.1.1. Interest Holder 1 - Primary Identification
Go to Section 4.1
Last name Given name(s)
City Province
City Country
Is the individual a Canadian citizen or permanent resident of Canada within the meaning of the Immigration and Refugee Protection Act (Canada)?
Is the individual’s principal residence in Canada?
Yes
Yes
No
NoIf yes:
If no:
Countries or states of citizenshipIf no:
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Last Known Address
Is the individual resident in Canada for the purposes of the Income Tax Act (Canada)? Yes No
If the reporting body is a:Go to Section 4.1.2.1
Relevant corporationGo to Section 4.1.2.2
Trustee of a relevant trustGo to Section 4.1.2.3
Partner of a relevant partnership
4.1.2. Interest Holder 1 - Additional InformationDate of birth (YYYY-MM-DD) Social insurance number Individual tax number
Individual does not have a SIN Individual does not have an ITN
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Transparency Report
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The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.1.2.1.1
Go to Section 4.1.2.1.2
Go to Section 4.1.2.4
Go to Section 4.1.2.4
4.1.2.1. Interest Holder 1 - Relevant Corporation
Describe how the individual is an interest holder by selecting one of the options below:
4.1.2.1.1. Interest Holder 1 - Relevant Corporation Option 1
4.1.2.1.2. Interest Holder 1 - Relevant Corporation Option 2
Select all sub-options that apply:
Select all sub-options that apply:
The individual has a beneficial interest in the land, other than an interest that is contingent on the death of another individual [s. 2(a)]
The individual is a corporate interest holder in respect of a relevant corporation that has a beneficial interest in the interest in land [s. 2(c)(i)]
The individual has the power to revoke the relevant trust and receive the interest in land [s. 2(b)]
The individual is a corporate interest holder in respect of a relevant corporation that has the power to revoke the relevant trust and receive the interest in land [s. 2(c)(ii)]
Go to Section 4.1.2.4
Go to Section 4.1.2.2.1
Go to Section 4.1.2.4
Go to Section 4.1.2.2.1
4.1.2.2. Interest Holder 1 - Trustee of a Relevant Trust
Describe how the individual is an interest holder by selecting one of the options below:
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
Go to Section 4.1.2.2.1.1
Go to Section 4.1.2.2.1.2
4.1.2.2.1. Interest Holder 1 - Trustee of a Relevant Trust Option 3 or 4Select one of the following options:
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Transparency Report
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An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [2. 3(2)(a)(iii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.1.2.4
Go to Section 4.1.2.4
Select all sub-options that apply:
Select all sub-options that apply:
4.1.2.2.1.1. Interest Holder 1 - Trustee of a Relevant Trust Option 3.1 or 4.1
4.1.2.2.1.2. Interest Holder 1 - Trustee of a Relevant Trust Option 3.2 or 4.2
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
4.1.2.3.1. Interest Holder 1 - Partner of a Relevant Partnership Option 2Select one of the following options:
The individual is a partner in the relevant partnership and has an interest, right or ability, as a partner, in respect of the interest in land being registered [s.4(2)(a) and 4(3)(a)]
The individual is a corporate interest holder in respect of a relevant corporation and the relevant corporation, which is a partner in the relevant partnership, and which has an interest, right or ability, as a partner, in respect of the interest in land being registered [s. 4(2)(b) and 4(3)(b)]
Go to Section 4.1.2.4
Go to Section 4.1.2.3.1.1
Go to Section 4.1.2.3.1
Go to Section 4.1.2.3.1.2
4.1.2.3. Interest Holder 1 - Partner of a Relevant Partnership
Describe how the individual is an interest holder by selecting one of the options below:
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
4.1.2.3.1.1. Interest Holder 1 - Partner of a Relevant Partnership Option 2.1Select all sub-options that apply:
Go to Section 4.1.2.4
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The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
4.1.2.3.1.2. Interest Holder 1 - Partner of a Relevant Partnership Option 2.2Select all sub-options that apply:
The interest meets criterion in s. 3(4)
Go to Section 4.1.2.4
Has a determination of incapacity been made in respect of this individual?
4.1.2.4. Interest Holder 1 - Additional Information About How the Individual is an Interest Holder
Provide any additional information about how the individual is an interest holder, if applicable.
For the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
Was the reporting body able to obtain and confirm the accuracy of all required information about the interest holder?
Date the individual became an interest holder (YYYY-MM-DD) Yes No
Yes No
If no:
Describe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the interest holder.
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the interest holder? Yes NoIf no:
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4.2. Interest Holder 2
4.2.1. Interest Holder 2 - Primary Identification
Last name Given name(s)
Is the individual a Canadian citizen or permanent resident of Canada within the meaning of the Immigration and Refugee Protection Act (Canada)? Yes No
Countries or states of citizenshipIf no:
City Province
City Country
Is the individual’s principal residence in Canada? Yes NoIf yes:
If no:
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Last Known Address
Is the individual resident in Canada for the purposes of the Income Tax Act (Canada)? Yes No
If the reporting body is a:Go to Section 4.2.2.1
Relevant corporationGo to Section 4.2.2.2
Trustee of a relevant trustGo to Section 4.2.2.3
Partner of a relevant partnership
4.2.2. Interest Holder 2 - Additional InformationDate of birth (YYYY-MM-DD) Social insurance number Individual tax number
Individual does not have a SIN Individual does not have an ITN
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation.
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation.
Go to Section 4.2.2.1.1
Go to Section 4.2.2.1.2
4.2.2.1. Interest Holder 2 - Relevant Corporation
Describe how the individual is an interest holder by selecting one of the options below:
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An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.2.2.4
4.2.2.1.1. Interest Holder 2 - Relevant Corporation Option 1Select all sub-options that apply:
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.2.2.4
4.2.2.1.2. Interest Holder 2 - Relevant Corporation Option 2Select all sub-options that apply:
The individual has a beneficial interest in the land, other than an interest that is contingent on the death of another individual [s. 2(a)]
The individual is a corporate interest holder in respect of a relevant corporation that has a beneficial interest in the interest in land [s. 2(c)(i)]
The individual has the power to revoke the relevant trust and receive the interest in land [s. 2(b)]
The individual is a corporate interest holder in respect of a relevant corporation that has the power to revoke the relevant trust and receive the interest in land [s. 2(c)(ii)]
Go to Section 4.2.2.4
Go to Section 4.2.2.2.1
Go to Section 4.2.2.4
Go to Section 4.2.2.2.1
4.2.2.2. Interest Holder 2 - Trustee of a Relevant Trust
Describe how the individual is an interest holder by selecting one of the options below:
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [2. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.2.2.4
4.2.2.2.1.1. Interest Holder 2 - Trustee of a Relevant Trust Option 3.1 or 4.1Select all sub-options that apply:
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
Go to Section 4.2.2.2.1.1
Go to Section 4.2.2.2.1.2
4.2.2.2.1. Interest Holder 2 - Trustee of a Relevant Trust Option 3 or 4
Select one of the following options:
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The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.2.2.4
4.2.2.2.1.2. Interest Holder 2 - Trustee of a Relevant Trust Option 3.2 or 4.2Select all sub-options that apply:
The individual is a partner in the relevant partnership and has an interest, right or ability, as a partner, in respect of the interest in land being registered [s.4(2)(a) and 4(3)(a)]
The individual is a corporate interest holder in respect of a relevant corporation and the relevant corporation, which is a partner in the relevant partnership, and which has an interest, right or ability, as a partner, in respect of the interest in land being registered [s. 4(2)(b) and 4(3)(b)]
Go to Section 4.2.2.4
Go to Section 4.2.2.3.1
4.2.2.3. Interest Holder 2 - Partner of a Relevant Partnership
Describe how the individual is an interest holder by selecting one of the options below:
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
4.2.2.3.1. Interest Holder 2 - Partner of a Relevant Partnership Option 2Select one of the following options:
Go to Section 4.2.2.3.1.1
Go to Section 4.2.2.3.1.2
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
4.2.2.3.1.1. Interest Holder 2 - Partner of a Relevant Partnership Option 2.1Select all sub-options that apply:
Go to Section 4.2.2.4
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
4.2.2.3.1.2. Interest Holder 2 - Partner of a Relevant Partnership Option 2.2Select all sub-options that apply:
The interest meets criterion in s. 3(4)
Go to Section 4.2.2.4
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4.2.2.4. Interest Holder 2 - Additional Information About How the Individual is an Interest Holder
Provide any additional information about how the individual is an interest holder, if applicable.
Has a determination of incapacity been made in respect of this individual?
Was the reporting body able to obtain and confirm the accuracy of all required information about the interest holder?
Date the individual became an interest holder (YYYY-MM-DD) Yes No
Yes No
For the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
If no:
Describe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the interest holder.
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the interest holder? Yes NoIf no:
4.3. Interest Holder 3
4.3.1. Interest Holder 3 - Primary Identification
Last name Given name(s)
Is the individual a Canadian citizen or permanent resident of Canada within the meaning of the Immigration and Refugee Protection Act (Canada)? Yes No
Countries or states of citizenshipIf no:
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City Province
City Country
Is the individual’s principal residence in Canada? Yes NoIf yes:
If no:
Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Last Known Address
4.3.2. Interest Holder 3 - Additional InformationDate of birth (YYYY-MM-DD) Social insurance number Individual tax number
Individual does not have a SIN Individual does not have an ITN
Is the individual resident in Canada for the purposes of the Income Tax Act (Canada)? Yes No
If the reporting body is a:Go to Section 4.3.2.1
Relevant corporationGo to Section 4.3.2.2
Trustee of a relevant trustGo to Section 4.3.2.3
Partner of a relevant partnership
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation.
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation.
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.3.2.1.1
Go to Section 4.3.2.1.2
Go to Section 4.3.2.4
4.3.2.1. Interest Holder 3 - Relevant Corporation
Describe how the individual is an interest holder by selecting one of the options below:
4.3.2.1.1. Interest Holder 3 - Relevant Corporation Option 1Select all sub-options that apply:
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The individual has a beneficial interest in the land, other than an interest that is contingent on the death of another individual [s. 2(a)]
The individual is a corporate interest holder in respect of a relevant corporation that has a beneficial interest in the interest in land [s. 2(c)(i)]
The individual has the power to revoke the relevant trust and receive the interest in land [s. 2(b)]
The individual is a corporate interest holder in respect of a relevant corporation that has the power to revoke the relevant trust and receive the interest in land [s. 2(c)(ii)]
Go to Section 4.3.2.4
Go to Section 4.3.2.2.1
Go to Section 4.3.2.4
Go to Section 4.3.2.2.1
4.3.2.2. Interest Holder 3 - Trustee of a Relevant Trust
Describe how the individual is an interest holder by selecting one of the options below:
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
Go to Section 4.3.2.2.1.1
Go to Section 4.3.2.2.1.2
4.3.2.2.1. Interest Holder 3 - Trustee of a Relevant Trust Option 3 or 4
Select one of the following options:
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.3.2.4
4.3.2.1.2. Interest Holder 3 - Relevant Corporation Option 2Select all sub-options that apply:
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [2. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.3.2.4
4.3.2.2.1.1. Interest Holder 3 - Trustee of a Relevant Trust Option 3.1 or 4.1Select all sub-options that apply:
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.3.2.4
4.3.2.2.1.2. Interest Holder 3 - Trustee of a Relevant Trust Option 3.2 or 4.2Select all sub-options that apply:
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The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
4.3.2.3.1. Interest Holder 3 - Partner of a Relevant Partnership Option 2Select one of the following options:
The individual is a partner in the relevant partnership and has an interest, right or ability, as a partner, in respect of the interest in land being registered [s.4(2)(a) and 4(3)(a)]
The individual is a corporate interest holder in respect of a relevant corporation and the relevant corporation, which is a partner in the relevant partnership, and which has an interest, right or ability, as a partner, in respect of the interest in land being registered [s. 4(2)(b) and 4(3)(b)]
Go to Section 4.3.2.4
Go to Section 4.3.2.3.1.1
Go to Section 4.3.2.3.1
Go to Section 4.3.2.3.1.2
4.3.2.3. Interest Holder 3 - Partner of a Relevant Partnership
Describe how the individual is an interest holder by selecting one of the options below:
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
4.3.2.3.1.1. Interest Holder 3 - Partner of a Relevant Partnership Option 2.1Select all sub-options that apply:
Go to Section 4.3.2.4
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
4.3.2.3.1.2. Interest Holder 3 - Partner of a Relevant Partnership Option 2.2Select all sub-options that apply:
The interest meets criterion in s. 3(4)
Go to Section 4.3.2.4
4.3.2.4. Interest Holder 3 - Additional Information About How the Individual is an Interest Holder
Provide any additional information about how the individual is an interest holder, if applicable.
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Has a determination of incapacity been made in respect of this individual?
For the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
Was the reporting body able to obtain and confirm the accuracy of all required information about the interest holder?
Date the individual became an interest holder (YYYY-MM-DD) Yes No
Yes No
If no:
Describe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the interest holder.
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the interest holder? Yes NoIf no:
4.4. Interest Holder 4
4.4.1. Interest Holder 4 - Primary Identification
Last name Given name(s)
City Province
City Country
Is the individual a Canadian citizen or permanent resident of Canada within the meaning of the Immigration and Refugee Protection Act (Canada)?
Is the individual’s principal residence in Canada?
Yes
Yes
No
NoIf yes:
If no:
Countries or states of citizenshipIf no:
4.4.2. Interest Holder 4 - Additional InformationDate of birth (YYYY-MM-DD) Social insurance number Individual tax number
Individual does not have a SIN Individual does not have an ITN
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Address 1 (Street No./Name)
City
Address 2 (Apt. No., PO Box, RR)
Province / state
Postal / ZIP code
Country
Last Known Address
Is the individual resident in Canada for the purposes of the Income Tax Act (Canada)? Yes No
If the reporting body is a:Go to Section 4.4.2.1
Relevant corporationGo to Section 4.4.2.2
Trustee of a relevant trustGo to Section 4.4.2.3
Partner of a relevant partnership
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation.
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation.
Go to Section 4.4.2.1.1
Go to Section 4.4.2.1.2
4.4.2.1. Interest Holder 4 - Relevant Corporation
Describe how the individual is an interest holder by selecting one of the options below:
An interest as a registered owner of one or more of the corporation’s shares [3(2)(a)(i)]
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.4.2.4
Go to Section 4.4.2.4
4.4.2.1.1. Interest Holder 4 - Relevant Corporation Option 1
4.4.2.1.2. Interest Holder 4 - Relevant Corporation Option 2
Select all sub-options that apply:
Select all sub-options that apply:
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An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [2. 3(2)(a)(iii)]
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.4.2.4
4.4.2.2.1.1. Interest Holder 4 - Trustee of a Relevant Trust Option 3.1 or 4.1Select all sub-options that apply:
The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
Go to Section 4.4.2.2.1.1
Go to Section 4.4.2.2.1.2
4.4.2.2.1 Interest Holder 4 - Trustee of a Relevant Trust Option 3 or 4
Select one of the following options:
The individual has a beneficial interest in the land, other than an interest that is contingent on the death of another individual [s. 2(a)]
The individual is a corporate interest holder in respect of a relevant corporation that has a beneficial interest in the interest in land [s. 2(c)(i)]
The individual has the power to revoke the relevant trust and receive the interest in land [s. 2(b)]
The individual is a corporate interest holder in respect of a relevant corporation that has the power to revoke the relevant trust and receive the interest in land [s. 2(c)(ii)]
Go to Section 4.4.2.4
Go to Section 4.4.2.2.1
Go to Section 4.4.2.4
Go to Section 4.4.2.2.2
4.4.2.2. Interest Holder 4 - Trustee of a Relevant Trust
Describe how the individual is an interest holder by selecting one of the options below:
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
Go to Section 4.4.2.4
Select all sub-options that apply:
The individual is a partner in the relevant partnership and has an interest, right or ability, as a partner, in respect of the interest in land being registered [s.4(2)(a) and 4(3)(a)]
The individual is a corporate interest holder in respect of a relevant corporation and the relevant corporation, which is a partner in the relevant partnership, and which has an interest, right or ability, as a partner, in respect of the interest in land being registered [s. 4(2)(b) and 4(3)(b)]
Go to Section 4.4.2.4
Go to Section 4.4.2.3.1
4.4.2.3. Interest Holder 4 - Partner of a Relevant Partnership
Describe how the individual is an interest holder by selecting one of the options below:
4.4.2.2.1.2. Interest Holder 4 - Trustee of a Relevant Trust Option 3.2 or 4.2
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The individual has the following interests or rights, or a combination of them, in a significant number of shares of the relevant corporation
The individual has the following rights or abilities, or a combination of them, in respect of a relevant corporation that if exercised would result in the election, appointment or removal of the majority of the directors of the relevant corporation
4.4.2.3.1. Interest Holder 4 - Partner of a Relevant Partnership Option 2Select one of the following options:
Go to Section 4.4.2.3.1.1
Go to Section 4.4.2.3.1.2
An interest as a registered owner of one or more of the corporation’s shares [s. 3(2)(a)(i)]
The right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(i)]
An interest as a beneficial owner of one or more of the corporation’s shares other than an interest that is contingent on the death of another individual [s. 3(2)(a)(ii)]
Indirect control, within the meaning of the regulations, of the right to elect, appoint or remove one or more of the corporation’s directors [s. 3(2)(b)(ii)]
Indirect control, within the meaning of the regulations, of one or more of the corporation’s shares [s. 3(2)(a)(iii)]
The ability to exercise direct and significant influence over an individual who meets the criterion of s. 3(2)(b)(i) or 3(2)(b)(ii)
Held solely
Held solely
Held solely
Held solely
Held solely
Held solely
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
Held jointly [s. 3(3)]
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
The interest meets criterion in s. 3(4)
4.4.2.3.1.1. Interest Holder 4 - Partner of a Relevant Partnership Option 2.1
4.4.2.3.1.2. Interest Holder 4 - Partner of a Relevant Partnership Option 2.2
Select all sub-options that apply:
Select all sub-options that apply:
The interest meets criterion in s. 3(4)
Go to Section 4.4.2.4
Go to Section 4.4.2.4
Has a determination of incapacity been made in respect of this individual?
4.4.2.4. Interest Holder 4 - Additional Information About How the Individual is an Interest Holder
Provide any additional information about how the individual is an interest holder, if applicable.
Was the reporting body able to obtain and confirm the accuracy of all required information about the interest holder?
Date the individual became an interest holder (YYYY-MM-DD) Yes No
Yes No
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For the information that the Reporting Body was not able to obtain or confirm, provide a summary of the steps taken to try to obtain and confirm the information.
If no:
Describe the steps the Reporting Body took under s. 24 of LOTA to give written notice to the interest holder.
Was the Reporting Body able to give the written notice required under s. 24 of LOTA to the interest holder? Yes NoIf no:
IMPORTANT – This section of Transparency Report must be signed by all certifiers.
I, having knowledge of the matters included in this transparency report and having the actual authority to certify this report as the reporting body or on behalf of the reporting body, I certify that this transparency report is correct and complete to the extent required under s. 15(7) and s. 25 of the Land Owner Transparency Act (LOTA). I understand and acknowledge that LOTA provides for administrative penalties under Division 4 of Part 4 and for fines and other monetary payments under Part 6 for the provision of false or misleading information in a transparency report.
5. Certifier Information
Certification date (YYYY-MM-DD)
Signature
Certifier 2 - Name (Printed)
Certification date (YYYY-MM-DD)
Signature
Certifier 1 - Name (Printed)
Phone number
Position/title
Position/title
Phone number
E-mail
E-mail
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Page 1 of 2
Declaration of exclusion from the Land Owner Transparency Act (LOTA)
Please only complete this form if you are filing an application to register an interest in land that is excluded from the requirements of LOTA. If the interest in land is not excluded under LOTA, you must file a transparency declaration and if also required, a transparency report. For further information, visit https://landtransparency.ca
Date:
To: The Registrar, Land Title Office,
Re: Application to the Registrar under section 168.2(2) of the Land Title Act to submit the attached Form __________ (state the name of the form(s)) in hardcopy form without a LOTA Transparency Declaration
Legal Description: ___________________________________________________________
___________________________________________________________
PID Number(s): ___________________________________________________________
I hereby certify that I am: (choose one) ☐ The Applicant.
☐ Solicitor (as the case may be) for (name of applicant) , the applicant for registration of the attached application.
☐ Authorized agent (as the case may be) for (name of applicant) , the applicant for registration of the attached application.
Continued on next page.
https://landtransparency.ca/
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Page 2 of 2
I certify that the attached application is excluded from the requirements of the Land Owner Transparency Act and therefore a Transparency Declaration is not required to be filed with this application for the following reason: (choose one)
☐ The interest in land(s) being transferred is not one of the following interests in land as defined in section 1 of LOTA:
(a) an estate in fee simple; (b) a life estate in land; (c) a right to occupy land under a lease that has a term of more than 10 years; (d) a right under an agreement for sale to
(i) occupy land, or (ii) require the transfer of an estate in fee simple;
Or
☐ The interest in land(s) being transferred is one of the following excluded Indigenous lands under section 6 of LOTA:
(a) treaty lands of a Treaty First Nation; (b) Nisg̱a'a Lands; (c) Nisg̱a'a Fee Simple Lands as defined in the Definitions Chapter of the Nisg̱a'a Final
Agreement; (d) Sechelt lands, as defined in section 2 (1) of the Sechelt Indian Band Self-
Government Act(Canada); (e) a reserve, as defined in section 2 (1) [definitions] of the Indian Act (Canada); (f) Other Maa-nulth First Nation Lands as defined in the Definitions Chapter of the Maa-
nulth First Nations Final Agreement; (g) Other Tla'amin Lands as defined in the Definitions Chapter of the Tla'amin Final
Agreement; (h) Other Tsawwassen Lands as defined in the Definitions Chapter of the Tsawwassen
First Nation Final Agreement.
_________________________________ ___________________________________ Name (Print Name) Signature
Transferee 2 Type: OffTransferee 2 is Reporting Body: OffReporting Body Type 2: OffTransferee 3 Type: OffTransferee 3 is Reporting Body: OffReporting Body Type 3: OffTransferee 4 Type: OffTransferee 4 is Reporting Body: OffReporting Body Type 4: OffCertifier 1 Date_af_date: Certifier 2 Date_af_date: Certifier 3 Date_af_date: Certifier 4 Date_af_date: Transferee 2 Corporation Legal Name: Transferee 2 Last Name: Transferee 2 Given Name(s): Transferee 2 Exempt from TR: OffTransferee 3 Corporation Legal Name: Transferee 3 Last Name: Transferee 3 Given Name(s): Transferee 3 Exempt from TR: OffTransferee 4 Corporation Legal Name: Transferee 4 Last Name: Transferee 4 Given Name(s): Transferee 4 Exempt from TR: OffCertifier 1 Transferee: Certifier 2 Transferee: Certifier 3 Name: Certifier 3 Transferee: Certifier 4 Name: Certifier 4 Transferee: 1: TR is Previously Filed: Off Transparency Report ID#: Land has PID: Off Land Identifier: Off
Charge Number 1 Legal Description 2: Charge Number 2 Legal Description 2: 2: Reporting Body Type: Off Trustee Type 1: Off Partner Type 2: Off1 Corporation/Legal Name: 1 Address 1: 1 Address 2: 1 Postal Code: 1 City: 1 Province: 1 Country: 1 Corporation has Head Office: Off1 Head Office is Same Address: Off1 Head Office Address 1: 1 Head Office Address 2: 1 Head Office Postal Code: 1 Head Office City: 1 Head Office Province: 1 Head Office Country: 1 Jurisdiction of incorporation: 1 Transferred Jurisdiction: 2 Last Name: 2 Given Name: 2 Individual is a Citizen or Permanent Resident: Off2 Countries of Citizenship: 2 Principal Residence is in Canada: Off2 Principal City: 2 Principal Providence: 2 Not Principal City: 2 Not Principal Country: 3 Partnership's Registered Business Name: 3 Partnership Type: Off3 Other Partnership Type: 3 Partnership Address 1: 3 Partnership Address 2: 3 Partnership Postal Code: 3 Partnership City: 3 Partnership Province: 3 Partnership Country: 3 Partnership's Premises is the Same: Off3 Principal Address 1: 3 Principal Address 2: 3 Principal Postal Code: 3 Principal City: 3 Principal Province: 3 Principal Country: 3 Jurisdiction:
3: 1 Corporation Business Number: 1 Corporation Other Identifying Number: 2 Reference Number of Trust Instrument: 2 Has Settlors: Off2: 1 Settlor 1 Type: Off1: 1 Settlor 1 Corporation/Legal Name: 1 Settlor 1 Address 1: 1 Settlor 1 Address 2: 1 Settlor 1 Postal Code: 1 Settlor 1 City: 1 Settlor 1 Province: 1 Settlor 1 Country: 1 Settlor Corporation has Head Office: Off1 Head Office is Same Address: Off1 Settlor 1 Head Office Address 1: 1 Settlor 1 Head Office Address 2: 1 Settlor 1 Head Office Postal Code: 1 Settlor 1 Head Office City: 1 Settlor 1 Head Office Province: 1 Settlor 1 Head Office Country: 1 Settlor 1 Jurisdiction of Incorporation: 1 Settlor 1 Transferred Jurisdiction: 1 Reporting Body was able to obtain and confirm settlor information: Off1 Reporting Body Obtain Information Summary: 1 Reporting Body able to given written notice: Off1 Reporting Body Written Notice Summary: 2 Last Name: 2 Given Names: 2 Individual is Citizen or Permanent Resident: Off2 Countries of Citizenship: 2 Principal Residence is in Canada: Off2 Principal City: 2 Principal Province: 2 Not Principal City: 2 Not Principal Country: 2: 2 Date of Birth_af_date: 2 Social Insurance Number: 2 No SIN: Off2 Individual Tax Number: 2 No ITN: Off2 Settlor 1 Address 1: 2 Settlor 1 Address 2: 2 Settlor 1 Postal Code: 2 Settlor 1 City: 2 Settlor 1 Province: 2 Settlor 1 Country: 2 Individual is Resident in Canada: Off2 Individual Determination of Incapacity: Off2 Reporting Body Obtain Settlor Information: Off2 Reporting Body Obtain Information Summary: 2 Reporting Body able to give written notice: Off2 Reporting Body Give Written Notice Summary:
2 Settlor 2 Type: Off2: 1 Settlor 2 Corporation/Legal Name: 1 Settlor 2 Address 1: 1 Settlor 2 Address 2: 1 Settlor 2 Postal Code: 1 Settlor 2 City: 1 Settlor 2 Province: 1 Settlor 2 Country: 1 Corporation has Head Office: Off1 Head Office Address is the Same: Off1 Settlor 2 Head Office Address 1: 1 Settlor 2 Head Office Address 2: 1 Settlor 2 Head Office Postal Code: 1 Settlor 2 Head Office City: 1 Settlor 2 Head Office Province: 1 Settlor 2 Head Office Country: 1 Settlor 2 Jurisdiction of Incorporation: 1 Settlor 2 Transferred Jurisdiction: 1 Reporting Body Able to Obtain Settlor Information: Off1 Reporting Body Obtain Information Summary: 1 Reporting Body Able to Give Written Notice: Off1 Reporting Body Written Notice Summary: 2: 1 Settlor 2 Last Name: 1 Settlor 2 Given Names: 1 Settlor 2 is Citizen or Permanent Resident: Off1 Settlor 2 Countries of Citizenship: 1 Settlor 2 Principal Residence is in Canada: Off1 Principal Residence City: 1 Principal Residence Province: 1 Not Principal Residence City: 1 Not Principal Residence Country: 2 Date of Birth_af_date: 2 Social Insurance Number: 2 No SIN: Off2 Individual Tax Number: 2 No ITN: Off2 Settlor 2 Address 1: 2 Settlor 2 Address 2: 2 Settlor 2 Postal Code: 2 Settlor 2 City: 2 Settlor 2 Province: 2 Settlor 2 Country: 2 Settlor 2 is Resident: Off2 Settlor 2 Has Determination of Incapacity: Off2 Reporting Body Able to Confirm Settlor 2: Off2 Reporting Body Confirm Information Summary: 2 Reporting Body Able to Give Written Notice: Off2 Reporting Body Written Notice Summary:
3 Partnership's Business Number: 3 Identifying Number:
4: Individuals are Interest Holders: Off LOTA Statement: 1 Last Name: 1 Given Names: 1 Individual is Canadian Citizen: Off1 Countries or States of Citizenship: 1 Principal Residence is in Canada: Off1 Principal Residence City: 1 Principal Residence Province: 1 Not Principal Residence City: 1 Not Principal Residence Country: 1: 2 Date of Birth_af_date: 2 Social Insurance Number: 2 No SIN: Off2 Individual Tax Number: 2 No ITN: Off2 Address 1: 2 Address 2: 2 Postal Code: 2 City: 2 Province: 2 Country: 2 Resident Income Tax Act: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
3 Options: Off3: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
4 Interest Holder Additional Information: 4 Date Became Interest Holder_af_date: 4 Individual Determination of Incapacity: Off4 Reporting Body Confirm Accuracy of Information: Off4 Reporting Body Obtain Information Summary: 4 Reporting Body Written Notice s: 24: Off
4 Reporting Body Written Notice Summary:
2: 1 Last Name: 1 Given Names: 1 Individual is Canadian Citizen: Off1 Countries or States of Citizenship: 1 Principal Residence is in Canada: Off1 Principal Residence City: 1 Principal Residence Province: 1 Not Principal Residence City: 1 Not Principal Residence Country: 2 Date of Birth_af_date: 2 Social Insurance Number: 2 No SIN: Off2 Individual Tax Number: 2 No ITN: Off2 Address 1: 2 Address 2: 2 Postal Code: 2 City: 2 Province: 2 Country: 2 Resident Income Tax Act: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
3 Options: Off3: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
4 Interest Holder Additional Information: 4 Date Became Interest Holder_af_date: 4 Individual Determination of Incapacity: Off4 Reporting Body Confirm Accuracy of Information: Off4 Reporting Body Obtain Information Summary: 4 Reporting Body Written Notice s: 24: Off
4 Reporting Body Written Notice Summary:
3: 1 Last Name: 1 Given Names: 1 Individual is Canadian Citizen: Off1 Countries or States of Citizenship: 1 Principal Residence is in Canada: Off1 Principal Residence City: 1 Principal Residence Province: 1 Not Principal Residence City: 1 Not Principal Residence Country: 2 Date of Birth_af_date: 1 Social Insurance Number: 1 No SIN: Off1 Individual Tax Number: 1 No ITN: Off2 Address 1: 2 Address 2: 2 Postal Code: 2 City: 2 Province: 2 Country: 2 Resident Income Tax Act: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
3 Options: Off3: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
4 Interest Holder Additional Information: 4 Date Became Interest Holder_af_date: 4 Individual Determination of Incapacity: Off4 Reporting Body Confirm Accuracy of Information: Off4 Reporting Body Obtain Information Summary: 4 Reporting Body Written Notice s: 24: Off
4 Reporting Body Written Notice Summary:
4: 1 Last Name: 1 Given Names: 1 Individual is Canadian Citizen: Off1 Countries or States of Citizenship: 1 Principal Residence is in Canada: Off1 Principal Residence City: 1 Principal Residence Province: 1 Not Principal Residence City: 1 Not Principal Residence Country: 2 Date of Birth_af_date: 2 Social Insurance Number: 2 No SIN: Off2 Individual Tax Number: 2 No ITN: Off2 Address 1: 2 Address 2: 2 Postal Code: 2 City: 2 Province: 2 Country: 2 Resident Income Tax Act: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
3 Options: Off3: 1 Options: Off1: 1 Options: Off1: 1 Options: Off2 Options: Off3 Options: Off
2 Options: Off2: 1 Options: Off2 Options: Off3 Options: Off
4 Interest Holder Additional Information: 4 Date Became Interest Holder_af_date: 4 Individual Determination of Incapacity: Off4 Reporting Body Confirm Accuracy of Information: Off4 Reporting Body Obtain Information Summary: 4 Reporting Body Written Notice s: 24: Off
4 Reporting Body Written Notice Summary:
Certifier 1 Name: Certifier 1 Title: Certifier 1 Certification Date_af_date: Certifier 1 Phone Number: Certifier 1 Email: Certifier 2 Name: Certifier 2 Title: Certifier 2 Certification Date_af_date: Certifier 2 Phone Number: Certifier 2 Email: PID 1: PID 2: PID 3: PID 4: PID 5: PID 6: PID 7: PID 8: Charge Number 1: Charge Number 2: Charge Number 1 Legal Description: Charge Number 2 Legal Description: Transferee 1 Type: OffTransferee 1 Corporation Legal Name: Transferee 1 Last Name: Transferee 1 Given Name(s): Transferee 1 is Reporting Body: OffReporting Body Type 1: OffTransferee 1 Exempt from TR: Off