Clerk’s Stamp

COURT FILE NUMBER

COURT Court of King’s Bench of Alberta

JUDICIAL CENTRE

PLAINTIFF

DEFENDANT

DOCUMENT WITHDRAWAL OF CERTIFICATE OF

LIS PENDENS

ADDRESS FOR SERVICE

AND CONTACT
INFORMATION OF PARTY
FILING THIS DOCUMENT

To: Registrar of Land Titles

THIS IS TO CERTIFY that the Certificate of Lis Pendens registered at the Land Titles Office for
the Alberta Land Registration District as Instrument Number on against the following lands:

[insert legal description]

is hereby withdrawn and discharged as against the aforesaid lands, the within proceedings having been
discontinued.

DATED at , Alberta,
City / Town / Municipality

on , , 20 ..
Date

Clerk of the Court

Withdrawal Certificate Lis Pendens November 2022