Common use of FORM OF ELECTION TO EXERCISE Clause in Contracts

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number Signature (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer must be guaranteed by a chartered bank or an eligible guarantor institution with membership in an approved signature guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature

Appears in 2 contracts

Samples: Shareholder Rights Plan Agreement (Tahoe Resources Inc.), Shareholder Rights Plan Agreement (Tahoe Resources Inc.)

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FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and ProvinceProvince or State) Social Insurance Number or other taxpayer identification number number. Dated: Signature (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and ProvinceProvince or State) Social Insurance Number or other taxpayer identification number number. Dated: Signature (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or trust company, a member firm of a recognized stock exchange in Canada, a registered national securities exchange in the United States, a member of the Investment Dealers Association of Canada or National Association of Securities Dealers, Inc. or a commercial bank or trust company having an eligible guarantor institution with membership office or correspondent in an approved signature guarantee medallion programCanada or the United States or a member of the Securities Transfer Association Medallion (Stamp) Program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSignature (Please print name of Signatory)

Appears in 2 contracts

Samples: Shareholder Rights Plan Agreement (Dirtt Environmental Solutions LTD), Shareholder Rights Plan Agreement (Dirtt Environmental Solutions LTD)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. ATS CORPORATION and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number Number, Social Security Number, or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number Number, Social Security Number, or other taxpayer identification number number. Dated: Signature (Signature Guaranteed: The signature on this election to exercise must correspond to with the name as written Signature Guaranteed: upon the face of this Rights Certificate the Right Certificate(s), in every particular, without alteration or enlargement enlargement, or any change whatsoever.) *The signature of the person executing this form of transfer whatsoever and must be guaranteed by a major Canadian Schedule I chartered bank or a member of an eligible guarantor institution with membership in an approved acceptable Medallion Signature Guarantee Program (STAMP, SEMP, MSP). The Guarantor must affix a stamp bearing the actual words “Signature Guaranteed”. In the USA, signature guarantee medallion programguarantees must be done by members of a “Medallion Signature Guarantee Program” only. Signature guarantees are not accepted from Treasury Branches, Credit Unions or Caisses Populaires unless they are members of the Stamp Medallion Program. The undersigned party Person exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms in this Certificate shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature

Appears in 2 contracts

Samples: Shareholder Rights Plan Agreement (ATS Corp /ATS), Shareholder Rights Plan Agreement (ATS Corp /ATS)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INCXXXX XXXXXX TIMBER CO. LTD. and COMPUTERSHARE INVESTOR SERVICES INC. AST TRUST COMPANY (CANADA) The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number Number, Social Security Number, or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number Number, Social Security Number, or other taxpayer identification number number. Dated: Signature Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature on this election to exercise must correspond with the name as written upon the face of the person executing this form of transfer Right Certificate(s), in every particular, without alteration or enlargement, or any change whatsoever and must be guaranteed by a major Canadian Schedule I chartered bank or a member of an eligible guarantor institution with membership in an approved signature guarantee medallion programacceptable Medallion Signature Guarantee Program (STAMP, SEMP, MSP). The undersigned party exercising Rights hereunderguarantor must affix a stamp bearing the actual words “Signature Guaranteed”. In the USA, hereby representssignature guarantees must be done by members of a “Medallion Signature Guarantee Program” only. Signature guarantees are not accepted from Treasury Branches, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate Credit Unions or Caisses Populaires unless they are not, and, to the knowledge members of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureStamp Medallion Program.

Appears in 2 contracts

Samples: Successor Rights Plan Agreement (West Fraser Timber Co., LTD), Shareholder Rights Plan Agreement (Norbord Inc.)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights represented by this Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. AND TO: Computershare Investor Services Inc. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) (Social Insurance Number or other taxpayer identification number number) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) (Social Insurance Number or other taxpayer identification number number) Dated: Signature: Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing signature(s) on this form of transfer must also be guaranteed by one of the following methods: In Canada and the US: a chartered Medallion Guarantee obtained from a member of an acceptable Medallion Guarantee Program (STAMP,SEMP or MSP). Many banks, credit unions and broker dealers are members of a Medallion Guarantee Program. The guarantor must affix a stamp in the space above bearing the actual words “Medallion Guaranteed”. In Canada: a Signature Guarantee obtained from a major Canadian Schedule I bank that is not a member of a Medallion Guarantee Program. The guarantor must affix a stamp in the space above bearing the actual words “Signature Guaranteed”. Outside Canada and the US: holders must obtain a guarantee from a local financial institution that has a corresponding affiliate in Canada or the US that is a member of an eligible guarantor institution with membership in an approved signature acceptable Medallion Guarantee Program. The corresponding affiliate must over guarantee medallion programthe guarantee provided by the local financial institution. CERTIFICATE The undersigned party exercising Rights hereunder, hereunder hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSignature (please print name of signatory)

Appears in 2 contracts

Samples: Shareholder Rights Plan Agreement (Caledonia Mining Corp), Shareholder Rights Plan Agreement (Caledonia Mining Corp)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES PROMIS NEUROSCIENCES INC. and AND TO: COMPUTERSHARE INVESTOR SERVICES INC. TRUST COMPANY OF CANADA The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) Dated: Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureAgreement dated as of January 22, 2016 between ProMIS Neurosciences Inc. and Computershare Trust Company of Canada

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE FALCO RESOURCES INCLTD. and COMPUTERSHARE INVESTOR SERVICES INC. TSX TRUST COMPANY The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in In the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Date: Signature Signature Guaranteed: (Signature signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer election to exercise must be guaranteed by a Schedule 1 Canadian chartered bank or an eligible guarantor institution with membership in an approved signature guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Amended and Restated Shareholder Rights Plan Agreement. Date: Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably elects to exercise _________________________________________ The undersigned hereby irrevocably elects to exercise _____________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. CERTIFICATE (To be completed if true.) The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSignature (Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Asanko Gold Inc.)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. World Color Press Inc. and COMPUTERSHARE INVESTOR SERVICES INC. Computershare Investor Services Inc. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number, Social Security Number or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number, Social Security Number or other taxpayer identification number number. Dated: Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a chartered bank Canadian Chartered Bank, a Canadian trust company, a member of a recognized stock exchange or an eligible guarantor institution with membership in an approved signature guarantee medallion programa member of the Securities Transfer Agent Medallion Program (STAMP). The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Voting Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature.

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (World Color Press Inc.)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INCXXXX XXXXXX TIMBER CO. LTD. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number Number, Social Security Number, or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number Number, Social Security Number, or other taxpayer identification number number. Dated: Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature on this election to exercise must correspond with the name as written upon the face of the person executing this form of transfer Right Certificate(s), in every particular, without alteration or enlargement, or any change whatsoever and must be guaranteed by a major Canadian Schedule I chartered bank or a member of an eligible acceptable Medallion Signature Guarantee Program (STAMP, SEMP, MSP). The guarantor institution with membership in an approved must affix a stamp bearing the actual words “Signature Guaranteed”. In the USA, signature guarantee medallion programguarantees must be done by members of a “Medallion Signature Guarantee Program” only. Signature guarantees are not accepted from Treasury Branches, Credit Unions or Caisses Populaires unless they are members of the Stamp Medallion Program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature(To be attached to each Rights Certificate.)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (West Fraser Timber Co., LTD)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES LEADING BRANDS, INC. and COMPUTERSHARE INVESTOR SERVICES INC. TRUST COMPANY OF CANADA The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ _whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in In the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer election to exercise must be guaranteed by a Schedule 1 Canadian chartered bank or an eligible guarantor institution with membership in an approved signature guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Leading Brands Inc)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares Units or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Dated: Signature Guaranteed: Signature (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian schedule I chartered bank bank, a licensed trust company in Canada, a member of the Securities Transfer Association Medallion Program (STAMP), a member of the Stock Exchange Medallion Program (SEMP) or an eligible guarantor institution with membership in an approved signature guarantee medallion programa member of the New York Stock Exchange Inc. Medallion Signature Program (MSP). The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common SharesUnits, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. thereof Capitalized terms shall have the meaning ascribed thereto in the Shareholder Unitholder Rights Plan Agreement. Signature.

Appears in 1 contract

Samples: Unitholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably elects to exercise _____________________________________ The undersigned hereby irrevocably elects to exercise ____________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) (Social Insurance Number or other taxpayer identification number number) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) (Social Insurance Number or other taxpayer identification number number) Dated Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer (Signature must be guaranteed by a member firm of a recognized stock exchange in Canada who is a member of the Stock Transfer Association Medallion Program (medallion guarantee), or a Schedule I Canadian chartered bank or an eligible guarantor institution with membership in an approved signature guarantee medallion program. major Canadian trust company.) The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Alberta Star Development Corp)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or trust company, a member firm of a recognized stock exchange in Canada a registered national securities exchange in the United States, a member of the Investment Dealers Association of Canada or National Association of Securities Dealers, Inc. or a commercial bank or trust company having an office or correspondent in Canada or the United States or a member of the Securities Transfer Association Medallion (Stamp) Program. major Canadian Schedule I bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature(Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably elects to exercise ________________________________________ The undersigned hereby irrevocably elects to exercise _____________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. CERTIFICATE (To be completed if true.) The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSignature (Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Taseko Mines LTD)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. Silvercorp Metals Inc. and COMPUTERSHARE INVESTOR SERVICES INC. Computershare Investor Services Inc. The undersigned hereby Irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in In the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Dated: _____________________________ ____________________________________________ Signature Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer election to exercise must be guaranteed by a chartered bank or an eligible guarantor institution with membership in an approved signature guarantee medallion program. Silvercorp\Shareholder rights plan The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Dated: _____________________________ ____________________________________________ Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Silvercorp Metals Inc)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Dated: Signature (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Dated: Signature (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or trust company, a member firm of a recognized stock exchange in Canada a registered national securities exchange in the United States, a member of the Investment Dealers Association of Canada or National Association of Securities Dealers, Inc. or a commercial bank or trust company having an office or correspondent in Canada or the United States or a member of the Securities Transfer Association Medallion (Stamp) Programan eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature(Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. ODYSSEY TRUST COMPANY AND TO: TANZANIAN GOLD CORPORATION The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities Common Shares be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number Signature Dated: __________________________________ Signature: __________________________________ (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature Guaranteed: Signature must be guaranteed by a Schedule 1 Canadian chartered bank bank, a major Canadian trust company or an eligible guarantor institution with membership in an approved signature guarantee medallion programa member of a recognized Medallion Signature Guarantee Program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of the Corporation, the Rights Agent and all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Dated: __________________________________ Signature: __________________________________ (Signature must correspond to name as written upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever) Signature Guaranteed: Signature must be guaranteed by a Schedule 1 Canadian chartered bank, a major Canadian trust company or a member of a recognized Medallion Signature Guarantee Program.

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Tanzanian Gold Corp)

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FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. Silvercorp Metals Inc. and COMPUTERSHARE INVESTOR SERVICES INC. Computershare Investor Services Inc. The undersigned hereby Irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in In the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Dated: Signature Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer election to exercise must be guaranteed by a chartered bank or an eligible guarantor institution with membership in an approved signature guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Dated: Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Silvercorp Metals Inc)

FORM OF ELECTION TO EXERCISE. (To be exercised by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. GEN III OIL CORPORATION The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares (or other securities, if applicable, securities or property) issuable upon the exercise of such Rights and requests that certificates for such Shares (or other securities or title to such property) be issued in the name of: (Name) (AddressStreet) (City and State or Province) Social Insurance Number (Country, Postal Code or other taxpayer identification number Zip Code) SOCIAL INSURANCE, SOCIAL SECURITY OR OTHER TAXPAYER IDENTIFICATION NUMBER If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (AddressStreet) (City and State or Province) Social Insurance Number (Country, Postal Code or other taxpayer identification number Zip Code) SOCIAL INSURANCE, SOCIAL SECURITY OR OTHER TAXPAYER IDENTIFICATION NUMBER Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The If the Form of Election to Exercise indicates that either Shares (or other securities or title to such property) or the balance of Rights not being exercised are to be issued to a person or persons other than the registered holder of the Rights Certificate, the signature of such holder on the person executing this form Form of transfer Election to Exercise must be guaranteed by a Canadian chartered bank bank, a Canadian trust company, a member of a recognized stock exchange or an eligible guarantor institution with membership in an approved signature guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge a member of the undersigned, have never been, Beneficially owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSecurities Transfer Association Medallion (STAMP) Program.

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INCGREEN RIVER GOLD CORP. and COMPUTERSHARE INVESTOR SERVICES INC. AND TO: Computershare Investor Services Inc. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) Dated: Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureAgreement of GREEN RIVER GOLD CORP.

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or trust company, a member firm of a recognized stock exchange in Canada, a registered national securities exchange in the United States, a member of the Investment Dealers Association of Canada or National Association of Securities Dealers, Inc. or a commercial bank or trust company having an eligible guarantor institution with membership office or correspondent in an approved signature guarantee medallion programCanada or the United States or a member of the Securities Transfer Association Medallion (Stamp) Program. The undersigned party exercising transferring Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. Signature(Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or trust company, a member firm of a recognized stock exchange in Canada a registered national securities exchange in the United States, a member of the Investment Dealers Association of Canada or National Association of Securities Dealers, Inc. or a commercial bank or trust company having an eligible guarantor institution with membership office or correspondent in an approved signature guarantee medallion programCanada or the United States or a member of the Securities Transfer Association Medallion (Stamp) Program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSignature (Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Stellar Biotechnologies, Inc.)

FORM OF ELECTION TO EXERCISE. (To be exercised by executed if the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. Pacific Corporate Trust Company 10xx Xxxxx, 000 Xxxx Xxxxxx Vancouver, BC V6C 3B8 The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities Common Shares be issued in the name of: (Name) (Address) (City and Province) : Social Insurance Number or other taxpayer identification number Other Taxpayer Identification Number: If such number of Rights shall not be all the whole Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such whole Rights shall be registered in the name of and delivered to: (Name) (Full Address) (City and Province) , including postal code: Social Insurance Number or other taxpayer identification number Signature (Signature must correspond to name as written Other Taxpayer Identification Number: Dated: [month, day, year] Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *Signature The signature of the person executing this form of transfer must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, warrants and certifies for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Right Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof of an Acquiring Person or a any Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized of an Acquiring Person (as such terms shall have the meaning ascribed thereto are defined in the Shareholder Protection Rights Plan Agreement). SignatureSignature (Signature must correspond to name as written upon the alteration or enlargement or any change whatsoever.)

Appears in 1 contract

Samples: Shareholder Protection Rights Plan Agreement (Western Wind Energy Corp)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES LOMIKO METALS INC. and AND TO: COMPUTERSHARE INVESTOR SERVICES INC. TRUST COMPANY OF CANADA The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) DATED: Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureAgreement of LOMIKO METALS INC.

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES SILVERCREST MINES INC. and COMPUTERSHARE INVESTOR SERVICES INC. AND TO: PACIFIC CORPORATE TRUST COMPANY The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) Dated: _______________________ Signature Guaranteed: Signature (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureAgreement of SilverCrest Mines Inc.

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Silvercrest Mines Inc)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. Computershare Investor Services Inc. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signatures must be guaranteed by a Canadian chartered bank bank, a Canadian trust company, a member firm of a recognized stock exchange in Canada, a member of a registered national securities exchange in the United States, or an eligible guarantor institution with membership in an approved signature guarantee medallion programa member of the Securities Transfer Association Medallion (STAMP) Program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSignature (Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Dragonwave Inc)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE RESOURCES INC. and COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably elects to exercise :________________________________________ The undersigned hereby irrevocably elects to exercise _____________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City and Province) Social Insurance Number or other taxpayer identification number number. Signature (Please print name of Signatory) Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a chartered major Canadian Schedule I bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. CERTIFICATE (To be completed if true.) The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereofany of the foregoing. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureSignature (Please print name of Signatory)

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Northern Dynasty Minerals LTD)

FORM OF ELECTION TO EXERCISE. (To be exercised executed by the registered holder if such holder desires to exercise the Rights Certificate.) TO: TAHOE VICTORY RESOURCES INC. and CORPORATION AND TO: COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby Irrevocably irrevocably elects to exercise _____________________________ whole Rights represented by the attached Rights Certificate to purchase the Common Shares or other securities, if applicable, issuable upon the exercise of such Rights and requests that certificates for such securities be issued in the name of: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Name) (Address) (City City, Province and ProvincePostal Code) (Social Insurance Number or other taxpayer identification number number) Dated: Signature Guaranteed: (Signature must correspond to name as written Signature Guaranteed: upon the face of this Rights Certificate in every particular, without alteration or enlargement or any change whatsoever.) *The signature of the person executing this form of transfer Signature must be guaranteed by a Canadian chartered bank or an eligible guarantor institution with membership in an approved signature medallion guarantee medallion program. The undersigned party exercising Rights hereunder, hereby represents, for the benefit of all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, and, to the knowledge of the undersigned, have never been, Beneficially owned Owned by an Acquiring Person or an Affiliate or Associate thereof or a Person acting jointly or in concert with an Acquiring Person or an Affiliate or Associate thereof. Capitalized terms shall have the meaning ascribed thereto in the Shareholder Rights Plan Agreement. SignatureAgreement of VICTORY RESOURCES CORPORATION

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

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