Consent by Occupant for Right of Entry

Please use the submit button at the bottom of the form to print this form once you have entered in all your information

(*) indicates required field

Concerning
*Land Description (example: NW-00-000-00-W0M)
*Settlement
quarter
section
township
range
meridian
- in -
or
*Land Description (example: 000000-00-00)
Plan
Lot
Block
Between

Applicant

*Name / Company Name:
*Address 1:
Address 2:
*City:
*Province:
*Postal Code:
*Phone:
Fax:
*Contact Person:
*Email:
- and -

Occupant

*Name / Company Name:
*Address 1:
Address 2:
*City:
*Province:
*Postal Code:
*Phone:
Fax:
*Contact Person:
*Email:
Consent of Occupant

I,
please enter full name below
Acknowledge receipt of a copy of an application and plan, dated:
date
I consent to the appropriate Panel granting a right of entry order in accordance with the application and plan.
It is understood that execution of this consent form does not in any way affect my rights to compensation.

Dated at 
Settlement/Town

 in the Province of Alberta this 
day

 day of 
month

 , 
year
Signature
Date
Witness
Name of Witness
Signature of Witness
Address of Witness
City
Province
Postal Code

Print, sign, attach required documents, and mail original to the following:


9th Floor, Forestry Building
9920 - 108 Street
Edmonton, AB T5K 2M4

Phone: 1-800-661-8864 or 780-422-1541
Fax: 780-422-0019