Environment and
Sustainable Resource Development
Public Land Sales
Farm Holdings Consolidation Program - Tender Bid Submission
Operations Division
For Departmental
Provincial Programs Branch
5th floor, South Petroleum Plaza
9915 – 108 Street
Application Number: PLS
Edmonton, Alberta, T5K 2G8
Telephone: 780-427-3570
Fax: 780-422-2545
Client I.D. Number:
http://esrd.alberta.ca/lands-forests/
Applicant's Full Surname & Given Names Or Corporation Name
Use Only
I/We
NOTE: If this bid submission is accepted, title will be issued only in the name(s) listed above. No changes will be accepted.
If title is to be held in more than one name, indicate if it is to be held as:
Joint Tenants or
Tenants in Common (state percentage of interest for each)
Full Mailing Address And Postal Code
Telephone Number
(
)
Hereby Submit The Following Tender For (Legal Description):
This section to be completed by individual bidders only.
Corporate and association bidders must complete the declaration on the back of this page.
1. I am/We are
Canadian Citizen(s) or Permanent
Resident(s) of Canada
Yes
No
18 years of age or older
Yes
Provincial Government Employee(s) (If yes,
attach approval pursuant to Public Service Act.)
No
Yes
No
2. I/We meet all other requirement(s) outlined in the public notice relating to the tender.
3.
I/We hereby tender the amount of $
4.
$
5.
GST Registrant
NOTE:
as purchase price for the above land.
(10% of reserve bid) is enclosed in the form of a certified cheque or postal/bank money order.
Yes
No
GST Registration Number
Bidder(S) Signature
Bidder(S) Signature
Bidder(S) Signature
Bidder(S) Signature
Bidder(S) Signature
Bidder(S) Signature
GST is payable on the total purchase price and (if applicable) on the value of any privately owned improvements, upon
final acceptance of a bid, unless the successful bidder is a registrant under the Goods and Services Tax.
Should a bid be declared accepted, and it is established later that the successful bidder did not meet the
requirement(s) outlined in the public notice, the sale may be cancelled, and the deposit forfeited.
For Departmental Use Only
Tender Opening
Date:
Amount Bid: $
Opened By:
Decision:
Amount Enclosed: $
Witness:
Refused
Unsuccessful Bidder
Cheque/Money Order Returned
Date:
Time:
Accepted
SIGNATURE FOR MINISTER OF ENVIRONMENT AND SUSTAINABLE
RESOURCE DEVELOPMENT
Successful Bidder
Down Payment (received)
$
GST on Total Purchase Price
$
Administration Fee & GST
$
Privately Owned Improvements
$
GST on Privately Owned Improvements
_____________________________
Signature
TOTAL
$
$
Less Amount Received
$
Total Owing
$
Personal information in this form is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act and will be used to administer
the Public Lands Act and its associated regulations. This form is a public record and is available to anyone. All information contained on this form (including personal information)
may be disclosed by Alberta Environment and Sustainable Resource Development to anyone requesting a copy in accordance with sections 166-167 of the Public Lands
Administration Regulation. For further information about the collection and use of this information, please contact 780-427-3570.
Jul 2014
Public Land Sales – FHCP Tender Bid Submission
Page 1 of 2
© 2014 Government of Alberta
Public Land Sales
Farm Holdings Consolidation Program - Tender Bid Submission
To Be Completed By Bidder For Corporation
Declaration
Name
I/We,
Address
in the Province of Alberta do solemnly declare that:
of
I am an agent of the above corporation.
I hold the office of
given herein.
in the said corporation and have a personal knowledge of the information
The above is a Canadian Corporation as defined in the Public Lands Act.
In addition, I meet all other requirements outlined in the public notice relating to the tender of the land described above.
The information given herein is true and correct.
Declared before me at the
of
in the Province of Alberta
_____________________________________________
this
day of
SIGNATURE OF APPLICANT
, 201
Notary Public , Commissioner For Oaths Or Justice Of The Peace
In And For The Province Of Alberta
Printed Or Stamped Name Of Commissioner For Oaths
And Date On Which Appointment Expires
Canadian Corporation As Defined By the Public Lands Act
Section 22.1 (3)
(a)
“Canadian corporation” means
(i)
in the case of a corporation with share capital, a corporation in which not less than 75% of the equity
shares are registered in the name of and beneficially owned by
(A)
one or more Canadian citizens or permanent residents as defined in the Immigration Act
(Canada),
(B)
one or more corporations with share capital, if in each case not less than 75% of its equity
shares are registered in the name of and beneficially owned by Canadian citizens or
permanent residents as defined in the Immigration Act (Canada),
(C)
one or more corporations without share capital, if in each case not less than 75% of its
members are Canadian citizens or permanent residents as defined in the Immigration Act
(Canada), or
(D)
any combination of persons or corporations referred to in paragraphs (A), (B) and (C),
or
(ii)
(b)
Jul 2014
in the case of a corporation without share capital, a corporation in which not less than 75% of its
members are Canadian citizens or permanent residents as defined in the Immigration Act (Canada);
“equity share” means any share of any class of shares of a corporation carrying full or limited voting rights
and any share of any class of shares of the corporation carrying voting rights by reason of a contingency
that has occurred and is continuing.
Public Land Sales – FHCP Tender Bid Submission
© 2014 Government of Alberta
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