Lien Search Request
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1One Stop Licence Shop Ltd.
Lien Search Request Form
FAX to (403) 341-3299 or e-mail to
corporate@1stop.ca
Person Requesting Search
Account Number
Business Name or Last Name
First Name
Middle Name
Street Address
City
Province
Postal Code
Circle Payment Type
Circle Method of Delivery (Choose only one)
FAX Number
CASH / ACCOUNT /
FAX / MAIL / E-MAIL (Enter e-mail address below)
CREDIT CARD / CHEQUE
___________________________________
______________
Serial Number(s) Search
Serial Number
Year
Make and Model
1.
Serial Number
Year
Make and Model
2.
Serial Number
Year
Make and Model
3.
Serial Number
Year
Make and Model
4.
Serial Number
Year
Make and Model
5.
Serial Number
Year
Make and Model
6.
Serial Number
Year
Make and Model
7.
Serial Number
Year
Make and Model
8.
Debtor Name(s) Search
Select One ____ Business ____ Individual
(dd/mm/yy)
Business Name or Last Name
First Name
Middle Name
Birthdate (if known)
Select One ____ Business ____ Individual
(dd/mm/yy)
Business Name or Last Name
First Name
Middle Name
Birthdate (if known)
Select One ____ Business ____ Individual
(dd/mm/yy)
Business Name or Last Name
First Name
Middle Name
Birthdate (if known)
Registration Number(s) Search
1.
2.
3.
Authorized Signature
Name of Person Authorized to Complete this Form (Print)
Telephone and FAX number
This information is being collected for the purposes of obtaining a Personal Property Lien search. Questions about the collection of this
information can be directed to the Freedom of Information and Protection of Privacy Coordinator for Alberta Registries, Research and
Program Support, P.O. Box 3140, Edmonton, Alberta T5J 2G7, (780) 422-7330
20/11/03
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Parent category: Legal