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Request to Change Contact Particulars

_______________________________________________________________________________________________________________________________________ April 2012 of 3 www.lawsociety.ab.ca

Please read and complete all applicable areas of this form (see Law Society rules 39(1), 41(1) and 42). Any omitted areas may delay processing time. Once the completed form is received by the Law Society of Alberta, your request will be processed as soon as possible. Please submit the completed form via fax, mail or email (see page two for our contact information). Law Society rule 42 requires that every member provide the following information, in writing, forthwith:

(1) (a) If engaged in the practice law, members must provide to the Executive Director their current business name and business address.

(b) If not engaged in the practice of law but employed, members must provide to the Executive Director their business address.

(2) If employed, inactive members must provide the Executive Director their business address. (4.1)(a)(b)(c) Every member must provide the Executive Director with their business phone number(s), business fax

number(s) and business email address to the extent the member has these facilities. (5) Every member must provide to the Executive Director their current residential address and current residential

phone number. Law Society rule 119.2 requires that only a lawyer practising with a law firm approved to operate a trust account is permitted to receive trust money. For further information contact Trust Safety at 1-800-661-9003 or email [email protected]. For further information regarding the Rules of the Law Society of Alberta, Legal Profession Act and the Code of Conduct, please visit our website at www.lawsociety.ab.ca The personal information collected in this form will be used by the Law Society for one or more purposes contemplated by the Legal Profession Act, the Rules of the Law Society, the Code of Conduct, or a resolution of the Benchers and will be accessible to all departments of the Law Society, including the Alberta Lawyers Insurance Association. The information may be used or disclosed by the Law Society, now or in the future, for regulatory purposes, including Law Society investigations and proceedings. We may contact you to obtain additional information, or to obtain clarification on the information you provided. Should you have any questions about the collection, use or disclosure of this information, please contact the Privacy Officer at (403) 229-4700.

Member Name:

Member ID:

A. Indicate PREVIOUS mailing address below

Name of Law Firm or Workplace (if applicable):

Street:

City:

Province:

Postal Code:

Country:

Main Telephone:

Main Fax:

Direct Telephone:

Direct Fax:

Direct Business Email Address:

For Inactive Members – Personal Email Address (optional):

Law Society of Alberta Request to Change Contact Particulars

_______________________________________________________________________________________________________________________________________


***Inactive/Non-Practising Members, please go to Section E***

B. TRUST ACCOUNT CHANGES

Are you the responsible lawyer at your law firm? Yes No

If yes and if you are leaving your existing law firm, you must make arrangements for a replacement responsible lawyer to be approved by the Law Society.

If you are not the responsible lawyer, you cannot accept trust money unless you are working at a law firm that has been approved to receive trust money.

Are you starting a new law firm? Yes No

If yes, you must complete the Application to Operate a Law Firm (if you intend to hold trust money) or the Application for Exemption (if you do NOT intend to hold trust money).

Do you currently maintain a trust account(s)? Yes No

If yes, please answer the following questions as they relate to your trust account(s):

Are you only changing the address of your existing law firm? Yes No

Are you closing your existing trust bank account(s)? Yes No

C. LAW FIRM OR WORKPLACE INFORMATION

Will your firm or workplace name change as a result of this move? Yes No

If yes, the new name is:

Will this change of address affect other lawyers in your workplace? Yes No

(This will allow us to followup with other members to ensure our records are accurate.)

Does this change of address apply to your Professional Corporation profile? Yes No

If no, the PC address is:

D. INSURANCE

Will your Professional Liability Insurance coverage be changing? Yes No

If yes, please contact the Membership Department to obtain required application forms and applicable fee information.

E. NEW ADDRESS INFORMATION

Effective date of change (MM/DD/YYYY):

Name of Law Firm or Workplace (if applicable):

Street:

(Please note: If you are an active member engaged in the practice of law, Rural Route addresses and PO Box Numbers are not sufficient. Please provide an address to which a courier could be sent.)

City:

Province:

Postal Code:

Country:

Telephone:

Fax:

Direct Telephone: Direct Fax:

Direct Email Address:

For Inactive Members – Personal Email Address (optional):

Law Society of Alberta Request to Change Contact Particulars

_______________________________________________________________________________________________________________________________________


I confirm that the above name and contact information is correct and request that the Law Society update its records accordingly.

Member or Representative Signature: _____________________________ Date: __________________________

Member Services Department, The Law Society of Alberta, #500, 919 – 11th

Avenue SW, Calgary, AB T2R 1P3 Direct Line: 403-229-4781 Toll Free: 1-800-661-9003 Fax: 403-228-1728 Email: [email protected]

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