LAND TITLE ACT
FORM C
(Section 233)
Province of British Columbia
GENERAL INSTRUMENT - PART 1
(This area for Land Title Office use)
(name, address, phone number and signature of applicant, applicant's solicitor or agent)
PARCEL IDENTIFIER(S) AND LEGAL DESCRIPTION(S) OF LAND:*
Strata Lot <@>, District Lot <@>, Leasehold Strata Plan <@>
Part 2 of this Instrument consists of (select one only)
Filed Standard Charge Terms
There is no Part 2 of this instrument
A selection of (a) includes any additional or modified terms referred to in Item 7 or in a schedule annexed to this instrument. If (c) is selected, the
charge described in Item 3 is released or discharged as a charge on the land described in Item 2.
(including postal address(es) and postal code(s)):*
ADDITIONAL OR MODIFIED TERMS:*
EXECUTIONS:** This instrument creates, assigns, modifies, enlarges, discharges or governs the priority of the interest(s) described in Item 3
and the Transferor(s) and every other signatory agree to be bound by this instrument, and acknowledge(s) receipt of a true copy of the filed
standard charge terms, if any.
Transferor(s) Signature(s)
<@>
(As to both signatures)
OFFICER CERTIFICATION:
Your signature constitutes a representation that you are a solicitor, notary public or other person authorized by the Evidence Act, R.S.B.C. 1996, c. 124, to take
affidavits for use in British Columbia and certifies the matters set out in Part 5 of the Land Title Act as they pertain to the execution of this instrument.
*If space insufficient, enter "SEE SCHEDULE" and attach schedule in Form E.
**If space insufficient, continue executions on additional page(s) in Form D.