For information only: Made by the Lieutenant Governor in Council (O.C. 148/2021) on May 27, 2021 pursuant to section 55 of the Civil Forfeiture Act. Notice of objection 1 A notice of objection to be filed with the Minister under section 1.6 of the Act must be in Form 1 of the Schedule. Repeal 2 The Victims Restitution and Compensation Payment Forms Regulation (AR 180/2004) is repealed. Schedule Notice of Objection Form 1 I, __________________, of ____________________, ___________________, and in (name) (name of city/town/district) (name of province/state) relation to Civil Forfeiture Office (CFO) File Number: ___________________________ (on Notice of Administrative Disposition) MAKE OATH/AFFIRM AND SAY THAT: 1 I have an interest in the following property (describe property): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 2 The origin, nature and extent of my interest in the property is as follows (place an "x" in the appropriate box and provide the requested information): [] A I own the property (describe how you came to own the property, who or where it came from and the nature of the transaction it was derived from): ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ [] B I do not own the property, but have a right to possess it (describe how you came to possess the property, who or where it came from, the nature of the transaction it was derived from and the name and address of the person who owns the property): ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ [] C I have some other interest in the property (describe the origin, nature and extent of your interest): ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ 3 I dispute disposition and forfeiture of the property for the following reason(s): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 4 My address for service of documents is as follows: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ SWORN / AFFIRMED BEFORE ME at the of ____________________ __ ___________________ in the Province of Alberta, this ________day of ________________________, 20____. ________________________________________ A Commissioner for Oaths in and for Alberta, or a Notary Public