Form 45-108F4
Notice of Specified Key Events
Instructions: This is the form of notice required under section 18 of Multilateral Instrument 45-108 Crowdfunding in New Brunswick, Nova Scotia and Ontario to be made available to holders of securities acquired under the crowdfunding prospectus exemption.
1. Issuer Name and Address |
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Full legal name: |
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Street address: |
Province/State: |
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Municipality: |
Postal code/Zip code: |
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Website: |
Country: |
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2. Specified Key Event |
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The event, as described in section 3, is (checkmark all that apply): □ a discontinuation of the issuer’s business □ a change in the issuer’s industry □ a change of control of the issuer Date on which the event occurred (yyyy/mm/dd): |
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3. Event Description |
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Provide a brief description of the event identified in section 2.
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4. Contact Person |
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Provide the following information for a person at the issuer who can be contacted regarding the event described in section 3. |
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Name: |
Title: |
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Email address: |
Telephone number: |
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Date of notice (yyyy/mm/dd): |
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