Common use of FORM OF ELECTION TO EXERCISE Clause in Contracts

FORM OF ELECTION TO EXERCISE. TO: NOVAGOLD RESOURCES INC. The undersigned hereby irrevocably elects to exercise whole Rights represented by the attached Rights Certificate to purchase the Common Shares issuable upon the exercise of such Rights and requests that certificates for such Shares be issued to: (NAME) (ADDRESS) (CITY AND STATE OR PROVINCE) 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 STATE OR PROVINCE) SOCIAL INSURANCE, SOCIAL SECURITY OR OTHER TAXPAYER NUMBER Dated Signature Guaranteed 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 must be guaranteed by a Canadian chartered bank, a major Canadian trust company or a member of a recognized stock exchange or a member of a recognized Medallion Program. To be completed if true The undersigned 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 any Person acting jointly or in consent with any of the foregoing or any Affiliate or Associate of such Person (as defined in the Rights Agreement). Signature

Appears in 2 contracts

Samples: Shareholder Rights Plan Agreement (Novagold Resources Inc), Shareholder Rights Plan Agreement (Novagold Resources Inc)

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FORM OF ELECTION TO EXERCISE. TO: NOVAGOLD RESOURCES GTR GROUP INC. The undersigned hereby irrevocably elects to exercise whole Rights represented by the attached Rights Certificate to purchase the Common Shares issuable upon the exercise of such Rights and requests that certificates for such Shares be issued to: (NAMEAddress) (ADDRESSCity and State or Province) (CITY AND STATE OR PROVINCE) Social Insurance, Social Security or Other Taxpayer 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: (NAMEAddress) (ADDRESSCity and State or Province) (CITY AND STATE OR PROVINCE) SOCIAL INSURANCESocial Insurance, SOCIAL SECURITY OR OTHER TAXPAYER NUMBER Dated Social Security or Other Taxpayer Number Date Signature Guaranteed 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 must be guaranteed by a Canadian chartered bank, a major Canadian trust company or a member of a recognized stock exchange or a member of a recognized the Transfer Association Medallion (Stamp) Program. [To be completed if true true] The undersigned 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 any Person acting jointly or in consent concert with any of the foregoing or any Affiliate or Associate of such Person (as defined in the Rights Agreement). Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Mad Catz Interactive Inc)

FORM OF ELECTION TO EXERCISE. TO: NOVAGOLD RESOURCES ALTAIR NANOTECHNOLOGIES INC. The undersigned hereby irrevocably elects to exercise whole Rights represented by the attached this Rights Certificate to purchase the Common Shares issuable upon the exercise of such Rights and requests that certificates for such Common Shares be issued in the name of and delivered to: (NAME) (ADDRESS) (CITY AND STATE OR PROVINCE) Rights Certificate No. Name Address City and State/Province Social Insurance No. 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 STATE OR PROVINCE) SOCIAL INSURANCE, SOCIAL SECURITY OR OTHER TAXPAYER NUMBER Dated Name Address City and State/Province Social Insurance No. or other taxpayer identification number Date: Signature Signature Guaranteed 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 must be guaranteed by a Canadian chartered bank, a bank or major Canadian trust company company, or a member of a recognized stock exchange or a member of a recognized the Securities Transfer Association Medallion ProgramProgram (STAMP). (To be completed by the holder if true true) The undersigned hereby represents, for the benefit of the Corporation and all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, not and, to the knowledge of the undersigned, have never been, Beneficially Owned by an Acquiring Person or by an Affiliate or Associate thereof or of an Acquiring Person, any other Person acting jointly or in consent concert with any of the foregoing an Acquiring Person or any Affiliate or Associate of any such other Person (as such terms are defined in the Rights Agreement). Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Altair Nanotechnologies Inc)

FORM OF ELECTION TO EXERCISE. TO: NOVAGOLD RESOURCES INCGLAMIS GOLD LTD. The undersigned hereby irrevocably elects to exercise whole Rights represented by the attached Rights Certificate to purchase the Common Shares issuable upon the exercise of such Rights and requests that certificates for such Shares be issued to: (NAME) (ADDRESS) (CITY AND STATE OR PROVINCE) If such number of Rights shall will not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall will be registered in the name of and delivered to: (NAME) (ADDRESS) (CITY AND STATE OR PROVINCE) SOCIAL INSURANCE, SOCIAL SECURITY OR OTHER TAXPAYER NUMBER Dated Signature Guaranteed 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 must be guaranteed by a Canadian chartered bank, a major Canadian trust company or a member of a recognized stock exchange or a member of a recognized the Transfer Association Medallion (Stamp) Program. To [The following is to be completed completed, if true true:] The undersigned 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 any Person acting jointly or in consent with any of the foregoing or any Affiliate or Associate of such Person (as defined in the Rights Agreement). Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Glamis Gold LTD)

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FORM OF ELECTION TO EXERCISE. TO: NOVAGOLD XXXXXXX RESOURCES LTD. AND TO: COMPUTERSHARE INVESTOR SERVICES INC. The undersigned hereby irrevocably elects to exercise whole Rights represented by the attached Rights Certificate to purchase the Common Shares issuable upon the exercise of such Rights and requests that certificates for such Shares be issued to: (NAMEName) (ADDRESSAddress) (CITY AND STATE OR PROVINCECity and Province or State) (Social Insurance Number or other taxpayer identification number) If such number of Rights shall are 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: (NAMEName) (ADDRESSAddress) (CITY AND STATE OR PROVINCECity and Province or State) SOCIAL INSURANCE, SOCIAL SECURITY OR OTHER TAXPAYER NUMBER Dated (Social Insurance Number or other taxpayer identification number) Dated: Signature: Signature Guaranteed Signature Guaranteed: (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 must be guaranteed by a Schedule 1 Canadian chartered bank, a major Canadian trust company or a member of a recognized stock exchange or a member of a recognized Medallion Guarantee Program. (To be completed if true true) The undersigned 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 any Person acting jointly or in consent concert with any of the foregoing or any Affiliate or Associate of such Person (all capitalized terms are used as defined in the Rights Agreement). Signature:

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement

FORM OF ELECTION TO EXERCISE. TO: NOVAGOLD RESOURCES INC. The undersigned hereby irrevocably elects to exercise whole Rights represented by the attached this Rights Certificate to purchase the Common Shares issuable upon the exercise of such Rights and requests that certificates for such Common Shares be issued in the name of and delivered to: (NAME) (ADDRESS) (CITY AND STATE OR PROVINCE) Name Address City and Province Social Insurance No. 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 STATE OR PROVINCE) SOCIAL INSURANCE, SOCIAL SECURITY OR OTHER TAXPAYER NUMBER Dated Name Address City and Province Social Insurance No. or other taxpayer identification number Date: Signature Signature Guaranteed 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 must be guaranteed by a Canadian chartered bank, a major Canadian trust company or company, a member firm of a recognized stock exchange in Canada, a member of a registered national securities exchange in the United States, or a member of a recognized the Securities Transfer Association Medallion (STAMP) Program. (To be completed by the holder if true true) The undersigned hereby certifies and represents, for the benefit of the Corporation and all holders of Rights and Common Shares, that the Rights evidenced by this Rights Certificate are not, not and, to the knowledge of the undersigned, have never been, Beneficially Owned by an Acquiring Person or by an Affiliate or Associate thereof of an Acquiring Person or any other Person acting jointly or in consent concert with any of the foregoing or any Affiliate or Associate of such Person (as such terms are defined in the Rights Agreement). Signature

Appears in 1 contract

Samples: Shareholder Rights Plan Agreement (Nortel Networks Corp)

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