REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, Odyssey Trust Company is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). TO: Columbia Care Inc. (the “Corporation”) 000 Xxxxx Xxxxxx, 00xx Xxxxx Xxx Xxxx, XX 00000 XXX AND TO: Odyssey Trust Company (the “Warrant Agent”) 323 – 000 Xxxxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate or DRS Advice hereby exercises the right to acquire (A) Common Shares of Columbia Care Inc. Exercise Price Payable: The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Shares that are issuable pursuant to the exercise of such Warrants on the terms specified in such Warrant Certificate and in the Warrant Indenture. The undersigned hereby acknowledges that the undersigned is aware that the Common Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, Computershare is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place).
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, Odyssey Trust Company is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). 000 Xxxxx Xxx., 00xx Xxxxx Xxx Xxxx, Xxx Xxxx, 00000 Attention: Xxxxxxxx Xxxx, Chief Executive Officer Stock Exchange Building 0000-000 0xx Xxxxxx XX Xxxxxxx, Xxxxxxx, X0X 0X0 Attention: Corporate Trust Re: Transfer of Notes Reference is hereby made to the Indenture, dated as of March 31, 2020 (the “Indenture”), between COLUMBIA CARE INC., as issuer (the “Corporation”), and ODYSSEY TRUST COMPANY as trustee. Capitalized terms used but not defined herein shall have the meanings given to them in the Indenture. (the “Transferor”) owns and proposes to transfer the Notes or interests in such Notes specified in Annex A hereto, in the principal amount of US$ (the “Transfer”), to (the “Transferee”), as further specified in Annex A hereto. In connection with the Transfer, the Transferor hereby certifies that
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, Computershare is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). Initial Principal Amount: ● CUSIP ● Authorization: Date: Schedule B – Form of Redemption Notice iANTHUS CAPITAL HOLDINGS, INC. To: Holders of 8.0% Senior Unsecured Convertible Debentures (the “Debentures”) of iAnthus Capital Holdings, Inc. (the “Corporation”) Note: All capitalized terms used herein have the meaning ascribed thereto in the Indenture mentioned below, unless otherwise indicated. Notice is hereby given pursuant to Section 4.3 of the convertible debenture indenture (the “Indenture”) dated as of February 28, 2017 between the Corporation and Computershare Trust Company of Canada (the “Trustee”), that the aggregate principal amount of $● of the $● of Debentures outstanding will be redeemed as of ● (the “Redemption Date”), upon payment of a redemption amount of $● for each $1,000 principal amount of Debentures, calculated based on the aggregate of (i) ●, and (ii) all accrued and unpaid interest hereon to and including the Redemption Date in the amount of $● being equal to the aggregate of $● (collectively, the “Redemption Price”). The Redemption Price will be payable upon presentation and surrender of the Debentures called for redemption at the following corporate trust office: 000 Xxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx X0X 0X0 Xxxxxx Attention: General Manager, Corporate Trust The interest upon the principal amount of Debentures called for redemption shall cease to be payable from and after the Redemption Date, unless payment of the Redemption Price shall not be made on presentation for surrender of such Debentures at the above-mentioned corporate trust office on or after the Redemption Date or prior to the setting aside of the Redemption Price pursuant to the Indenture. In this connection, upon presentation and surrender of the Debentures for payment on the Redemption Date, the Corporation shall, on the Redemption Date, make the delivery to the Trustee, at the above-mentioned corporate trust office, for delivery to and on account of the holders, cash for all accrued and un...
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, Computershare is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). Initial Principal Amount: ● CUSIP 00000XXX0 Authorization: Date: TO: VALEO PHARMA INC. AND TO: COMPUTERSHARE TRUST COMPANY OF CANADA Note: All capitalized terms used herein have the meaning ascribed thereto in the Indenture mentioned below, unless otherwise indicated. The undersigned registered holder of 12% Convertible Unsecured Subordinated Debentures irrevocably elects to convert such Debentures (or $ principal amount thereof`) in accordance with the terms of the Indenture referred to in such Debentures and tenders herewith the Debentures, and, if applicable, directs that the Common Shares of VALEO PHARMA INC. (the “Corporation”) issuable upon a conversion be issued and delivered to the person indicated below. (If Common Shares are to be issued in the name of a person other than the holder, all requisite transfer taxes must be tendered by the undersigned). (If Common Shares are to be issued in the name of a person other than the holder, all requisite transfer taxes must be tendered by the undersigned and a Residency Declaration Form must be completed and delivered in respect of such other person). Conversion Price: The undersigned hereby acknowledges that the undersigned is aware that the Common Shares received on conversion may be subject to restrictions on resale under applicable securities legislation. If the Debentures are being converted by, or for the account or benefit of a U.S. Person or a Person in the United States, the undersigned represents, warrants and certifies as follows (one only) of the following must be checked)::
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, TSX Trust Company is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place).
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, TSX Trust Company is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). To: The Limestone Boat Company Limited Note: All capitalized terms used herein have the meaning ascribed thereto in the Indenture mentioned below, unless otherwise indicated. The undersigned registered holder of 10.0% Subordinated Unsecured Convertible Debentures irrevocably elects to convert such Debentures (or $• principal amount thereof*) in accordance with the terms of the Indenture referred to in such Debentures and tenders herewith the Debentures and directs that the Common Shares of The Limestone Boat Company Limited issuable upon a conversion be issued and delivered to the person indicated below. (If Common Shares are to be issued in the name of a person other than the holder, all requisite transfer taxes must be tendered by the undersigned and a Residency Declaration Form must be completed and delivered in respect of such other person). Dated: (Signature of Registered Holder) * If less than the full principal amount of the Debentures, indicate in the space provided the principal amount (which must be $1,000 or integral multiples thereof).
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, Capital Transfer Agency, ULC is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). To: CANSORTIUM INC. Note: All capitalized terms used herein have the meaning ascribed thereto in the Indenture mentioned below, unless otherwise indicated. The undersigned registered holder of 12% Secured Convertible Debentures irrevocably elects to convert such Debentures (or US$● principal amount thereof*) in accordance with the terms of the Indenture referred to in such Debentures and tenders herewith the Debentures and directs that the Common Shares of Cansortium Inc. issuable upon a conversion be issued and delivered to the Person indicated below. (If Common Shares are to be issued in the name of a Person other than the holder, all requisite transfer taxes must be tendered by the undersigned and a Residency Declaration Form must be completed and delivered in respect of such other Person).
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Trust Company of Canada is required to request cost basis information from US securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized, but rather the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). SCHEDULE “B” TO: Valeo Pharma Inc. (the “Corporation”) The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Shares of Valeo Pharma Inc. Exercise Price Payable: ((A) multiplied by $0.60, subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Shares that are issuable pursuant to the exercise of such Warrants on the terms specified in such Warrant Certificate and in the Warrant Indenture. The undersigned hereby acknowledges that the undersigned is aware that the Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
REASON FOR TRANSFER – FOR US CITIZENS OR RESIDENTS ONLY. Consistent with U.S. IRS regulations, TSX Trust Company is required to request cost basis information from U.S. securityholders. Please indicate the reason for requesting the transfer as well as the date of event relating to the reason. The event date is not the day in which the transfer is finalized but, rather, the date of the event which led to the transfer request (i.e. date of gift, date of death of the securityholder, or the date the private sale took place). MARICANN GROUP INC. (the “Corporation”) for value received hereby acknowledges itself indebted and, subject to the provisions of the Debenture Indenture (the “Indenture”) dated as of October 27, 2017 between the Corporation and TSX TRUST COMPANY (the “Trustee”), promises to pay to , the registered holder hereof on October 27, 2020 or on such earlier date as the principal amount hereof may become due in accordance with the provisions of the Indenture (any such date, the “Maturity Date”) the principal sum of ● Dollars ($●) in lawful money of Canada on presentation and surrender of this Debenture at the main branch of the Trustee in Toronto, Ontario in accordance with the terms of the Indenture and, subject as hereinafter provided, to pay interest on the principal amount hereof from, and including, the date hereof, or from the last Interest Payment Date to which interest shall have been paid or made available for payment hereon, whichever is later, at the rate of 9.0% per annum (based on a year of 360 days comprised of twelve 30-day months), in like money, in arrears in equal (with the exception of the first interest payment which will include interest from October 27, 2017 as set forth below) semi-annual instalments (less any tax required by law to be deducted) on the last day of August and February in each year commencing on February 28, 2018 and the last payment (representing interest payable from the last Interest Payment Date to, but excluding, the Maturity Date) to fall due on the Maturity Date and, should the Corporation at any time make default in the payment of any principal, premium, if any, or interest, to pay interest on the amount in default at the same rate, in like money and on the same dates. For certainty, the first interest payment will include interest accrued from October 27, 2017 to February 28, 2018, which will be equal to $31.00 for each $1,000 principal amount of the Debentures. This Debenture is one of the 9.0% Secured Convertible Debentures of the Corporation issued under ...
