C-81, r. 1 - Regulation respecting the application of the Public Curator Act

Schedule Disposition versions

2015-09-01

SCHEDULE I.1

(Revoked)

O.C. 594-99, Sch. I.1; O.C. 594-99; O.C. 203-2000, s. 5; O.C. 584-2015, s. 10.

2012-09-01

SCHEDULE I.1

(s. 6.3)

STATEMENT CONCERNING UNCLAIMED PROPERTY

(A) DECLARATION OF DEBTOR OR HOLDER OF UNCLAIMED PROPERTY

NAME: ___________________________________________________________________________________

ADDRESS: ________________________________________________________________________________

TELEPHONE: ______________________________________________________________________________

FAX:______________________________________________________________________________________

PERIOD COVERED BY THIS STATEMENT:

from __________________________________________ to __________________________________________

I, the undersigned,______, acting on my own behalf or, as the case may be, as a duly authorized representative of the institution, business or other organization, identified above, declare that:

(1) as a debtor or holder of unclaimed property, I am hereby filing the statement prescribed under the Public Curator Act with a description of all the property held that has become unclaimed property within the meaning of the Act in the period indicated above;

(2) a written notice as prescribed by section 26 of the Public Curator Act was given to the assigns for each unclaimed property described in this statement, except for the cases where reasons recognized by the Act or the regulation thereunder are relied on and indicated with respect to that property under the title “Other necessary or applicable information” below; and

(3) all the facts in this statement are accurate.

SIGNED at _________________________________, on _________________________________, 20________

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(Signature)

(B) DESCRIPTION OF UNCLAIMED PROERTY AND RELATED INFORMATION

               Identity      
                 and        
               domicile 
              of assigns
              including
               the date                                    Interest
               of birth                                    payable        Other 
Description    and the      Nature                value    (s. 26.5     necessary      
     of         social       and      Documents     of      P.C.A.)   or applicable
 unclaimed    insurance     origin      filed    property              information
 property       number     of right
                 

O.C. 594-99, Sch. I.1; O.C. 594-99; O.C. 203-2000, s. 5.