PROVINCE OF ALBERTA MORTGAGE

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1 Province of Alberta Land Titles Act R.S.A Sec. 113(2 PROVINCE OF ALBERTA MORTGAGE MORTGAGE 1. The parties to the Mortgage are: (a Borrower: (b Lender: HSBC BANK CANADA (c The address and postal code of the Lender is: 2. The legal description of the Lands is: (See Schedule A attached hereto 3. Terms The following terms are incorporated herein: (a Residential - Standard Form Mortgage Terms filed as number: Edmonton Land Titles Office Calgary Land Titles Office (b Demand - Standard Form Mortgage Terms filed as number: Edmonton Land Titles Office Calgary Land Titles Office (c Equity Power - Standard Form Mortgage Terms filed as number: Edmonton Land Titles Office Calgary Land Titles Office 4. Repayment Provisions (a The Principal Amount secured under the Mortgage is: $ (b The Amount of Each Periodic Payment to be made under the Mortgage: $ (c The First Payment Date under the Mortgage: (d The Interest Rate is: % per annum % per annum above the Lender s Prime Rate E_ /7

2 (e The Interest Calculation Period is: [monthly] [annually] [semi annually] not in advance. (f The Balance Due Date of the Mortgage is: (g Interest Adjustment Date is: (h Payment Dates: (i Term: 5. High Ratio Mortgages This mortgage is a high ratio mortgage to which sections 43(4.1 and (4.2 and 44(4.1 and (4.2 of the Law of Property Act apply. You and anyone who, expressly or impliedly, assumes this mortgage from you, could be sued for any obligations under this mortgage if there is a default by you or by a person who assumes this mortgage. The above provision is applicable to this mortgage. The above provision is not applicable to this mortgage. 6. The Mortgage consists of the above terms and is subject to the terms contained in the Standard Form Mortgage that was filed with the Alberta Registrar of Land titles and described in paragraph 3 above and as varied by any deletions from or amendments or additions to the terms contained in the Standard Form Mortgage and described in paragraph 8 below. 7. BORROWER S COVENANTS AND EXECUTION The undersigned Borrower hereby acknowledges that the Borrower (a understands the nature of the statement referred to in paragraph 6 above; (b has been given a copy of the Standard Form Mortgage referred to in paragraph 6 above; (c is the registered owner of the land being mortgaged; and (d mortgages all of the Borrower s estate and interest in the Lands for the purpose of securing the payment of the principal amount, interest and all other amounts secured by the Mortgage. 8. ADDITIONAL, MODIFIED OR DELETED TERMS (IF SPACE INSUFFICIENT, ENTER SEE SCHEDULE EXECUTED AND DELIVERED by the Borrower this day of, E_ /7

3 (Add full name(s of Borrower(s as they appear on title, if Corporation(s affix corporate seal(s, if individual(s the appropriate Dower Act compliances must be signed, witness(es to the signature(s must sign to the left of the individual(s signature(s and must swear affidavit(s of execution to be attached. SIGNED, SEALED AND DELIVERED in the presence of: BORROWER WITNESS BORROWER E_ /7

4 Consent of Spouse I,, being married to the above named, do hereby give my consent to the of the homestead made by this Mortgage and I have executed this Consent for the purpose of giving up my life estate and other dower rights in the said homestead given to me by the Dower Act (Alberta to the extent necessary to give effect to the said disposition. WITNESS Signature of Spouse CERTIFICATE OF ACKNOWLEDGEMENT BY SPOUSE 1. This document was acknowledged before me by apart from her husband (or his wife. 2. acknowledged to me that she (or he: (a is aware of the nature of the disposition; (b is aware that THE DOWER ACT gives her (or him a life estate in the homestead and the right to prevent disposition of the homestead by withholding consent; (c consents to the disposition for the purpose of giving up the life estate and other dower rights in the homestead given to her (or him by The Dower Act to the extent necessary to give effect to the said disposition; (d is executing the document freely and voluntarily without any compulsion on the part of her husband (or his wife. DATED at the of, in the Province of Alberta, this day of,. A Commissioner for Oaths in and for Alberta E_ /7

5 FORM B (Section 4 DOWER ACT AFFIDAVIT I,, of,, (occupation MAKE OATH AND SAY: 1. I am the Borrower (or the agent acting under power of attorney in my favour registered in the Land Titles Office on, as instrument number, granted by the Borrower named in the within (or annexed instrument. 2. I am (or my principal is not married. OR Neither myself nor my spouse (or my principal nor his spouse have resided on the within mentioned land at any time since our (or their marriage. OR I am (or my principal is married to, being the person who executed the release of dower rights registered in the Land Titles Office on,, as instrument number. OR A judgment for damages was obtained against me by my spouse (or my principal by his spouse and registered in the the Land Titles Office on,, as instrument number. SWORN BEFORE ME at the of in the Province of Alberta, this day of,. A Commissioner for Oaths in and for Alberta E_ /7

6 Affidavit of Execution CANADA PROVINCE OF ALBERTA TO WIT I,, of the of, in the Province of Alberta, MAKE OATH AND SAY AS FOLLOWS: 1. I was personally present and did see, named in the within instrument, who is (are personally known to me to be the person(s named therein, duly sign and execute the same for the purposes named therein. 2. That the same was executed at the of, in the Province of Alberta, and that I am the subscribing witness thereto. 3. That I know the said and is (are, in my belief, of the full age of eighteen years. SWORN BEFORE ME at the of in the Province of Alberta, this day of,. A Commissioner for Oaths in and for Alberta E_ /7

7 SCHEDULE A (legal description of the Lands specifically mortgaged Permitted Encumbrances: E_ /7

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