SAMPLE FORM

You may use this form to record your information or you may create your own form. If you create your own form,
ensure that it contains the same information as shown below.
Affix Microfilm Label Here

Notice of Address/Change of Address for an

Alberta Society
Public (when completed) Societies Act
Section 24(2)
This information is collected, used and may be publicly disclosed in accordance with s. 33(a,c), 39(1)(a,c) and 40(1)(c,e,f) of the Freedom of Information
and Protection of Privacy Act; the Societies Act and the Common Business Number Act. The information is required to issue a certificate of
incorporation, assign a Canada Revenue Agency business number and for notice and service to the society. Questions can be directed to the Service
Alberta and Red Tape Reduction Contact Centre at cr@gov.ab.ca or 780-427-7013 (toll-free 310-0000 within Alberta).

1. Society Name 2. Corporate Access Number 3. Business Number (optional)

4. Registered Office
Street Address or Legal Land Description City or Town Province Postal Code

5. Mailing Address (if applicable)

Post Office Box City or Town Province Postal Code

6. Society Email Address (mandatory)

Email Address

7. Authorized Representative/Authorized Signing Authority for the Society

Last Name First Name Middle Name (optional)

Relationship to Society Email Address (optional) Phone Number (optional)

Date of Submission yyyy-mm-dd Signature

I, , certify that the information I have

Authorized Representative
provided is true and correct to the best of my knowledge and that I am authorized to file this form on behalf of the society.

FOR OFFICE USE ONLY

REG0022 Rev. 2023-05 Page 1 of 2

 Notice of Address/Change of Address for an Alberta Society
Societies Act

INSTRUCTIONS
Use this form to submit address information at the time of incorporation or continuance into Alberta or to report a change of address
for the society. Address changes must be sent to Corporate Registry within 15 days of the change.

Item 1. Society Name

● Enter the full society name as it appears on the application for incorporation or continuance or the certificate of
incorporation, amalgamation, or continuance.

Item 2. Corporate Access Number

● When reporting a change of address, enter the corporate access number of the society. It appears on any
certificate or document issued by the Registrar of Corporations.

Item 3. Business Number

● Enter the business number, if known.
● For continuance into Alberta, the Business Number must be supplied, if one has previously been assigned to the
organization.

Item 4. Registered Office

● Enter the street address or legal land description (physical location) for the registered office of the society.

● The registered office must be in Alberta.

● For change of address, enter the new street address or legal land description. If you enter a legal land description,
you must provide a post office box in item 5.

Item 5. Mailing Address

● This address must be supplied when the registered office cannot receive mail.

● Enter the post office box or bag number.

● The mailing address must be in Alberta.

● For change of address, enter the new mailing address or 'n/a' if a mailing address no longer applies.

Item 6. Email Address (mandatory)

● Enter the society's email address. You must provide an email address so the society can receive an email reminder
when the Corporate Registry annual return is due.

Item 7. Authorized Representative/Authorized Signing Authority for the Society

● The authorized representative of the society must sign and date the notice and indicate their relationship to the
society.
● A daytime phone number and email address should be provided, if available.

Send the completed form to:

Mail to: Email: For information, contact:
Corporate Registry cr.npcompliance@gov.ab.ca Telephone: 780-427-7013
Service Alberta and Red Tape Reduction Toll-free inside Alberta:
Box 1007 Station Main Dial 310-0000 before the phone number
Edmonton AB T5J 4W6

REG0022 Rev. 2023-05 Page 2 of 2