FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Computershare Trust Company of Canada Computershare Investor Services Ltd. as registrar and transfer agent for the Warrants and Common Shares issuable upon exercise of the Warrants of MGX Minerals Inc.. The undersigned (a) acknowledges that the sale of the securities of MGX Minerals Inc. (the “Corporation”) to which this declaration relates is being made in reliance on Rule 904 of Regulation S under the United States Securities Act of 1933, as amended (the “U.S. Securities Act”) and (b) certifies that (1) the undersigned is not an affiliate of the Corporation as that term is defined in the 1933 Act, (2) the offer of such securities was not made to a person in the United States and either (A) at the time the buy order was originated, the buyer was outside the United States, or the seller and any person acting on its behalf reasonably believed that the buyer was outside the United States, or (B) the transaction was executed in, on or through the facilities of The Toronto Stock Exchange or any other designated offshore securities market as defined in Regulation S under the U.S. Securities Act and neither the seller nor any person acting on its behalf knows that the transaction has been prearranged with a buyer in the United States, (3) neither the seller nor any affiliate of the seller nor any person acting on any of their behalf has engaged or will engage in any directed selling efforts in the United States in connection with the offer and sale of such securities, (4) the sale is bona fide and not for the purpose of “washing off” the resale restrictions imposed because the securities are “restricted securities” (as such term is defined in Rule 144(a)(3) under the U.S. Securities Act), (5) the seller does not intend to replace the securities sold in reliance on Rule 904 of the U.S. Securities Act with fungible unrestricted securities and (6) the contemplated sale is not a transaction, or part of a series of transactions which, although in technical compliance with Regulation S, is part of a plan or scheme to evade the registration provisions of the U.S. Securities Act. Terms used herein have the meanings given to them by Regulation S. <@> Per: Name: Title: DATED this <@>day of<@>, 20<@>. FORM OF U.S. PURCHASER CERTIFICATION UPON EXERCISE OF WARRANTS MGX Minerals Inc. 0000 Xxxx Xxxxxx Suite 303 Vancouver, BC V6Z 2T1 - and to - Computershare Trust Company of Canada. as Warrant Agent Dear Sirs: We are delivering this letter in connection with the purchase o...
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Verano Holdings Corp. (the “Corporation”)
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Computershare Trust Company of Canada as registrar and transfer agent
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Odyssey Trust Company, as warrant agent [or TO: , as the Corporation’s transfer agent]
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Americas Silver Corporation (the “Corporation”)
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: EARTHRENEW INC. (the "Company") AND TO: TSX TRUST COMPANY 000 – 000 Xxxxxxxx Xxxxxx Xxxx Xxxxxxx, Xxxxxxx X0X 0X0 The undersigned (a) acknowledges that the sale of of EARTHRENEW INC. (the "Company") represented by certificate number to which this declaration relates is being made in reliance on Rule 904 of Regulation S under the United States Securities Act of 1933, as amended (the "U.S. Securities Act") and (b) certifies that (1) the undersigned is not an affiliate of the Company as that term is defined in Rule 405 under the United States Securities Act of 1933, of a "distributor" as defined in Regulation S or an affiliate of a distributor;
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Odyssey Trust Company, as warrant agent [ or TO: , as the Corporation’s transfer agent] AND TO: Caldas Gold Corp. (the “Corporation”) The undersigned (A) acknowledges that the sale of of the Corporation represented by certificate number to which this declaration relates is being made in reliance on Rule 904 of Regulation S under the United States Securities Act of 1933, as amended (the “U.S. Securities Act”), and (B) certifies that: (1) the undersigned is not
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: MPX BIOCEUTICAL CORPORATION (the “Corporation”)
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Xxxxxx Xxxxxxxxx LLP, as subscription receipt agent for the subscription receipts of Petro Viking Energy Inc.
FORM OF DECLARATION FOR REMOVAL OF LEGEND. TO: Olympia Trust Company, as registrar and transfer agent for Trust Units of StarPoint Energy Trust
