Form 45-106F17
Notice of Specified Key Events
This is the form required under subsection 2.9(17.20) of National Instrument 45-106 Prospectus Exemptions (NI 45-106) in New Brunswick, Nova Scotia and Ontario to make available notice of specified key events to holders of securities acquired under subsection 2.9(2.1) of NI 45-106.
1. Issuer Name and Address |
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Provide the following information. |
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Full legal name |
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2. Specified Key Event |
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Provide the following information. The event, as described in section 3, is: [Select one or more type of event from the list below]
□ 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 |
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Title |
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Email address |
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Telephone number |
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Date of notice (yyyy/mm/dd):