LAP: Recovery of Compensation

Please use the submit button at the bottom of the form to print this form once you have entered in all your information
Between

Applicant

*Name / Company Name:
*Address 1:
Address 2:
*City:
*Province:
*Postal Code:
*Phone:
Fax:
*Contact Person:
*Email:
- and -
*Name / Company Name:
*Address 1:
Address 2:
*City:
*Province:
*Postal Code:
*Phone:
Fax:
*Contact Person:
*Email:

What type of agreement was made? (please check one of the below boxes)

Right of Entry Order
Provide REO Number
Lease Agreement (if checked please attach a copy of the agreement)
Land Description: (example: NW-00-000-00-W0M)
Occupant(s):
Required Documentation
I certify that the information on this application is true.
Authorized Signature
Date

Print, sign, attach required documents, and mail original to the following:


Metis Settlements Appeal Tribunal
Suite 200, 10335 – 172 Street
Edmonton, Alberta T5S 1K9

Phone: 1-800-661-8864 or 780-422-1541
Fax: 780-422-0019