ADULT INTERDEPENDENT PARTNER AGREEMENT …

1 Published by Alberta Queen s Printer E-mail: Shop on-line at Alberta Queen s Printer Suite 700, Park Plaza 10611 - 98 Avenue Edmonton, AB T5K 2P7 Phone: 780-427-4952 Fax: 780-452-0668 Province of Alberta Extract Alberta Regulation 66/2011 ADULT INTERDEPENDENT RELATIONSHIPS ACT ADULT INTERDEPENDENT PARTNER AGREEMENT REGULATION Copyright and Permission Statement Alberta Queen's Printer holds copyright on behalf of the Government of Alberta in right of Her Majesty the Queen for all Government of Alberta legislation. Alberta Queen's Printer permits any person to reproduce Alberta s statutes and regulations without seeking permission and without charge, provided due diligence is exercised to ensure the accuracy of the materials produced, and Crown copyright is acknowledged in the following format: Alberta Queen's Printer, 20__.

2 * *The year of first publication of the legal materials is to be completed. Note All persons making use of this document are reminded that it has no legislative sanction. The official Statutes and Regulations should be consulted for all purposes of interpreting and applying the law. (no amdt) ALBERTA REGULATION 66/2011 ADULT INTERDEPENDENT Relationships Act ADULT INTERDEPENDENT PARTNER AGREEMENT REGULATION Form of AGREEMENT 1 An ADULT INTERDEPENDENT PARTNER AGREEMENT under section 7 of the Act must be in the form set out in the Schedule. Expiry 2 For the purpose of ensuring that this Regulation is reviewed for ongoing relevancy and necessity, with the option that it may be repassed in its present or an amended form following a review, this Regulation expires on June 30, 2020.

3 Repeal 3 The ADULT INTERDEPENDENT PARTNER AGREEMENT Regulation (AR 141/2003) is repealed. Coming into force 4 This Regulation comes into force on the coming into force of the Wills and Succession Act. Schedule ADULT INTERDEPENDENT PARTNER AGREEMENT BETWEEN: (Name and address of ADULT INTERDEPENDENT PARTNER ) and (Name and address of ADULT INTERDEPENDENT PARTNER ) We understand that by entering into this AGREEMENT we will become each other s ADULT INTERDEPENDENT PARTNER and will have all the benefits and obligations of ADULT INTERDEPENDENT partners under Alberta law. 1 We agree that Schedule AR 66/2011 ADULT INTERDEPENDENT PARTNER AGREEMENT REGULATION 2 (a) each of us is 16 years of age or older, (b) neither of us is a party to an ongoing marriage or ADULT INTERDEPENDENT PARTNER AGREEMENT , and (c) we are living or intend to live together in a relationship of interdependence.

4 2 We understand that this AGREEMENT will expire if we become former ADULT INTERDEPENDENT partners pursuant to the ADULT INTERDEPENDENT Relationships Act. In witness whereof we have executed this AGREEMENT in the (city, town, county) of (province, state, country) this day of , 20 . Witness (Print Name and Address) ADULT INTERDEPENDENT PARTNER Witness (Print Name and Address) Witness (Print Name and Address) ADULT INTERDEPENDENT PARTNER Witness (Print Name and Address) Guardians signatures (if applicable): Date: Date.

5 Guardian Guardian (Print name) (Print name) NOTES: 1. Each ADULT INTERDEPENDENT PARTNER s signature must be witnessed by 2 witnesses. 2. If either ADULT INTERDEPENDENT PARTNER is under the age of 18 years, the guardians of that person must sign above indicating their consent to the person entering into the ADULT INTERDEPENDENT PARTNER AGREEMENT . Schedule AR 66/2011 ADULT INTERDEPENDENT PARTNER AGREEMENT REGULATION 33. A person who is under the age of 18 years may not enter into an ADULT INTERDEPENDENT PARTNER AGREEMENT if the person is related to the other party by blood or adoption.

6 4. An ADULT INTERDEPENDENT PARTNER AGREEMENT may be part of or attached to another AGREEMENT between the parties. 5. If an ADULT INTERDEPENDENT PARTNER AGREEMENT is part of or attached to another AGREEMENT between the parties that contains one or more provisions relating to the property of one or both of the parties, the parties are advised to seek legal advice as to their rights and obligations in respect of that property. Printed on Recycled Paper*9780779757336*