Form 45-102F1 Notice of Intention to Distribute Securities under Section 2.8 of NI 45-102 Resale of Securities Reporting issuer 1. Name of reporting issuer: Selling security holder 2. Your name: 3. The offices or positions you hold in the reporting issuer: 4. Are you selling securities as a lender, pledgee, mortgagee or other encumbrancer? 5. Number and class of securities of the reporting issuer you beneficially own: Distribution 6. Number and class of securities you propose to sell: 7. Will you sell the securities privately or on an exchange or market? If on an exchange or market, provide the name. Warning It is an offence to submit information that, in a material respect and in light of the circumstances in which it is submitted, is misleading or untrue. Certificate I certify that (1) I have no knowledge of a material fact or material change with respect to the issuer of the securities that has not been generally disclosed; and (2) the information given in this form is true and complete. Date ...................................... ............................................… Your name (Selling security holder) .........................................….. Your signature (or if a company, the signature of your authorized signatory) ............................................... Name of your authorized signatory INSTRUCTION: File this form electronically through SEDAR with the securities regulatory authority or regulator in each jurisdiction where you sell securities and with the Canadian exchange on which the securities are listed.
If the securities are being sold on an exchange, the form should be filed in every jurisdiction across Canada. Notice to selling security holders - collection and use of personal information The personal information required in this form is collected for and used by the listed securities regulatory authorities or regulators to administer and enforce securities legislation in their jurisdictions. This form is publicly available by authority of National Instrument 45-102 and the securities legislation in each of the jurisdictions. The personal information collected will not be used or disclosed other than for the stated purposes without first obtaining your consent. Corporate filers should seek the consent of any individuals whose personal information appears in this form before filing this form If you have questions about the collection and use of your personal information, or the personal information of your authorized signatory, contact any of the securities regulatory authorities or regulators listed below. British Columbia Securities Commission P.O. Box 10142, Pacific Centre 701 West Georgia Street Vancouver, BC V7Y 1L2 Attention: Assistant Manager, Financial Reporting Telephone: (604) 899-6805 or (800) 373-6393 (in B.C.) Facsimile: (604) 899-6506 Alberta Securities Commission Suite 600, 250-5th Street SW Calgary, AB T2P 0R4 Attention: Information Officer Telephone: (403) 297-6454 Facsimile: (403) 297-6156 Saskatchewan Financial Services Commission Securities Division 601 - 1919 Saskatchewan Drive Regina, SK S4P 4H2 Attention: Deputy Director, Legal/Registration Telephone: (306) 787-5879 Facsimile: (306) 787-5899 Ontario Securities Commission Suite 1903, Box 55 20 Queen Street West Toronto, ON M5H 3S8 Attention: Administrative Support Clerk Telephone: (416) 593-3684 Toll free in Canada: 1-877-785-1555 Facsimile: (416) 593-8122 Autorité des marchés financiers Tour de la Bourse 800 square Victoria
C.P. 246, 22e étage Montréal, Québec H4Z 1G3 Attention: Responsable de l’accès à l’information Telephone: (514) 395-0337 Toll free: 1-877-525-0337 Facsimile: (514) 873-6155 (For filing purposes only) Facsimile: (514) 864-6381 (For privacy requests only) www.lautorite.qc.ca New Brunswick Securities Commission 85 Charlotte Street, Suite 300 Saint John, New Brunswick E2L 2J2 Telephone: (506) 658-3060 Toll Free in New Brunswick 1-866-933-2222 Facsimile: (506) 658-3059 Nova Scotia Securities Commission Suite 400, 5251 Duke Street Halifax, NS B3J 1P3 Attention: Corporate Finance Telephone: (902) 424-7768 Facsimile: (902) 424-4625 Prince Edward Island Securities Office 95 Rochford Street, 4 th Floor Shaw Building P.O. Box 2000 Charlottetown, Prince Edward Island C1A 7N8 Telephone: (902) 368-4569 Facsimile: (902) 368-5283 Government of Newfoundland and Labrador Financial Services Regulation Division P.O. Box 8700 Confederation Building 2nd Floor, West Block Prince Philip Drive St. John’s, NFLD A1B 4J6 Attention: Director of Securities Telephone: (709) 729-4189 Facsimile: (709) 729-6187 Government of Yukon Department of Community Services Law Centre, 3rd Floor 2130 Second Avenue Whitehorse, YT Y1A 5H6 Telephone: (867) 667-5314 Facsimile: (867) 393-6251
Government of Northwest Territories Office of the Superintendent of Securities Deputy Superintendent, Legal & Enforcement PO Box 1320 Yellowknife, NT X1A 2L9 Tel: (867) 920-8984 Fax: (867) 873-0243 Department of Justice, Nunavut Legal Registries Division P.O. Box 1000, Station 570 1st Floor, Brown Building Iqaluit, NT X0A 0H0 Attention: Director, Legal Registries Division Telephone: (867) 975-6590 Facsimile: (867) 975-6594
You are being directed to the most recent version of the statute which may not be the version considered at the time of the judgment.