REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. 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):
Appears in 2 contracts
Samples: Warrant Indenture (Invictus MD Strategies Corp.), Warrant Indenture (Invictus MD Strategies Corp.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada SCHEDULE “B” EXERCISE FORM 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX Xxxxxxx Xxxxxxxx, Xxxxxx X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Kuya Silver Corporation Exercise Price Payable: ((A) multiplied by $2.60, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. SILVERCREST METALS INC. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Corp. SilverCrest Metals Inc. Total Exercise Price Payable: ((A) multiplied by $1.45, subject to adjustment) 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 As at the time of exercise hereunder, the undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):follows:
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. NIOCORP DEVELOPMENTS LTD. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 510 Xxxxxxx Xxxxxx, Xxxxxx Xxxxxxxxx, XX Xxxxxxx Xxxxxxxx X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate or DRS Advice Slip hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: NIOCORP DEVELOPMENTS LTD. 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):
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US U.S. IRS regulations, Computershare is required to request cost basis information from US 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: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd FloorSuite 170 – 000 Xxxxxxxx Xx. Vancouver, 000 Xxxxxxx Xxxxxx, BC V6B 2Z4 Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Mind Cure Health Inc. (the “Company”) Exercise Price Payable: (A) multiplied by $0.80, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd FloorMINDSET PHARMA INC. (the "Company") 0xx Xxxxx, 000 Xxxxxxx Xxxxxx, XxxxxxxxxXxxxxxxxx XX, XX X0X 0X0 8th Floor, 000 Xxxxxxxxxx Xxxxxx, Xxxxxxx XX, X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Mindset Pharma Inc. Exercise Price Payable: ((A) multiplied by $1.10, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Corp. Bright Minds Biosciences Inc. Exercise Price Payable: __________________________________________________ ((A) multiplied by $9.46, subject to adjustment) 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. Any capitalized term in this Warrant Certificate that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Endeavor Trust Corporation 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd FloorXxxxx 000, 000 Xxxxxxx Xxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: CLOUDMD SOFTWARE & SERVICES INC. 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. Eat Well Investment Group Inc. (the “Corporation”) AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. the Corporation. Exercise Price Payable: ((A) multiplied by $0.75, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US U.S. IRS regulations, Computershare is required to request cost basis information from US 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: Invictus MD Strategies Corp. Field Trip Health Ltd. AND TO: Computershare Trust Company of Canada 3rd Floor800, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx000-0xx Xxxxxx XX Xxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) _ Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: Field Trip Health Ltd. (the “Corporation”) pursuant to the right of such holder to be issued, and hereby subscribes for, the Common Shares that are issuable pursuant to the exercise of such Warrants on the terms specified in such Warrant Certificate and in the Indenture for an aggregate exercise price of $__________________. 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):
Appears in 1 contract
REASON FOR TRANSFER – FOR US 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). TO: Invictus MD Strategies Bunker Hill Mining Corp. (the “Corporation”) AND TO: Computershare Trust Company of Canada 3rd Floor, 000 500 Xxxxxxx XxxxxxXxxxxx Vancouver, Xxxxxxxxx, XX X0X 0X0 British Columbia V6C 3B9 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Bunker Hill Mining Corp. 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):
Appears in 1 contract
Samples: Supplemental Warrant Indenture (Bunker Hill Mining Corp.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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 EXERCISE FORM TO: Invictus MD Strategies Corp. MGX Minerals Inc. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: MGX Minerals Inc. ((A) multiplied by $1.15, subject to adjustment) 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. Any capitalized term in this Warrant Certificate that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare National Securities Administrators Ltd. 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, StillCanna Inc. 000 Xxxxxxx XxxxxxXxxxxx Xx – #000, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. StillCanna Inc. Exercise Price Payable: ((A) multiplied by $1.73, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. GOLD STANDARD VENTURES CORP. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Gold Standard Ventures Corp. Exercise Price Payable: __________________________________________________ ((A) multiplied by $1.00, subject to adjustment) 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):
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. NORTHERN DYNASTY MINERALS LTD. AND TO: Computershare Trust Company of Canada 3rd 2nd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX XX, Xxxxxx, X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. NORTHERN DYNASTY MINERALS LTD. Exercise Price Payable: __________________________________________________ ((A) multiplied by $0.65, subject to adjustment) 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):.
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Endeavor is required to request cost basis information from US 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. i.e., date of gift, date of death of the securityholder, or the date the private sale took place). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, Suite 702 – 000 Xxxxxxx Xxxxxx, Xxxxxx Xxxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Euro Asia Pay Holdings Inc. Exercise Price Payable: ((A) multiplied by $0.45, subject to adjustment) 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 IndentureIndenture dated February 25, 2021. 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Odyssey Trust Company 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). TO: Invictus MD Strategies Corp. ACREAGE HOLDINGS, INC. AND TO: Computershare Odyssey Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Fixed Shares of Invictus MD Strategies Corp. Acreage Holdings, Inc. Total Exercise Price Payable: ((A) multiplied by $4.00, subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Fixed 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 Fixed Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. The As at the time of exercise hereunder, the undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):follows:
Appears in 1 contract
Samples: Supplemental Warrant Indenture (Acreage Holdings, Inc.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Global Gaming Technologies Corp. Exercise Price Payable: adjustment) 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. And for greater clarity, subject to adjustment thereof in the events and in the manner set forth in the Warrant Indenture hereinafter referred to, the exercise price payable for one Common Share upon the exercise of 10 Warrants shall be $17.50 and Warrants may only be exercised in a sufficient number to acquire whole numbers of Common Shares. 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):
Appears in 1 contract
Samples: Second Supplemental Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. SCHEDULE "B" EXERCISE NOTICE AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx0xx Floor Vancouver, XX X0X 0X0 BC V6C 3B9 The undersigned holder of the Warrants evidenced by this Warrant Certificate or the DRS Advice hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. The Very Good Food Company Inc. Exercise Price Payable: ((A) multiplied by $2.00, subject to adjustment) 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 or the DRS Advice 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 legislationlaws. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare National Securities Administrators Ltd. 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx XxxxxxXxxxxx Xx – #000, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Mydecine Innovations Group Inc. Exercise Price Payable: ((A) multiplied by $0.70, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. ENCORE ENERGY CORP. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies enCore Energy Corp. 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. Any capitalized term in this Warrant Certificate that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. TOWER ONE WIRELESS CORP. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares or Common Shares and Incentive Warrants, as applicable of Invictus MD Strategies Tower One Wireless Corp. Exercise Price Payable: __________________________________________________ ((A) multiplied by $0.____, subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Shares or Common Shares and Incentive Warrants, as applicable 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):
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US U.S. IRS regulations, Computershare is required to request cost basis information from US 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: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd FloorXxxxx 000 – 000 Xxxxxxxx Xx. Vancouver, 000 Xxxxxxx Xxxxxx, BC V6B 2Z4 Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Mind Cure Health Inc. (the “Company”) Exercise Price Payable: (A) multiplied by $0.80, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: ((A) multiplied by $2.35, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 OR 000 Xxxxxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxx, Xxxxxxx, X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies New Wave Esports Corp. Exercise Price Payable: ((A) multiplied by $0.18, subject to adjustment) 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):
Appears in 1 contract
Samples: Supplemental Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada SCHEDULE “B” EXERCISE FORM 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: Good Life Networks Inc. 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Odyssey Trust Company 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). TO: Invictus MD Strategies Corp. ACREAGE HOLDINGS, INC. AND TO: Computershare Odyssey Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Floating Shares of Invictus MD Strategies Corp. Acreage Holdings, Inc. Total Exercise Price Payable: ((A) multiplied by $4.00, subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Floating 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 Floating Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. The As at the time of exercise hereunder, the undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):follows:
Appears in 1 contract
Samples: Supplemental Warrant Indenture (Acreage Holdings, Inc.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Odyssey Trust Company 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 SCHEDULE “B” EXERCISE FORM The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Avicanna Inc. Total Exercise Price Payable: ((A) multiplied by $1.20, subject to adjustment) 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 As at the time of exercise hereunder, the undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):follows:
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 LEGAL*54381978.3 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. LABRADOR URANIUM INC. Exercise Price Payable: ((A) multiplied by $1.05, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. Quipt Home Medical Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Quipt Home Medical Corp. 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):
Appears in 1 contract
Samples: First Supplemental Indenture (Quipt Home Medical Corp.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Jet Metal Corp. AND TO: Computershare Trust Company of Canada 3rd 2nd Floor, 000 500 Xxxxxxx XxxxxxXxxxxx Vancouver, Xxxxxxxxx, XX X0X 0X0 BC V6C 3B9 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Jet Metal Corp. Exercise Price Payable: __________________________________________________ ((A) multiplied by $0.25, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture (Jet Metal Corp.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Capital Transfer Agency 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). TO: Invictus MD Strategies Corp. Bunker Hill Mining Corp.. (the “Corporation”) AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 Capital Transfer Agency ULC The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Bunker Hill Mining Corp. Exercise Price Payable: ((A) multiplied by $0.37, subject to adjustment) 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):
Appears in 1 contract
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. NioCorp Developments Ltd. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Corp. NioCorp Developments Ltd. 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):
Appears in 1 contract
REASON FOR TRANSFER – FOR US 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). TO: Invictus MD Strategies Bunker Hill Mining Corp. (the “Company”) AND TO: Computershare Trust Company of Canada 3rd Floor, 000 500 Xxxxxxx XxxxxxXxxxxx Vancouver, Xxxxxxxxx, XX X0X 0X0 British Columbia V6C 3B9 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Bunker Hill Mining Corp. 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):
Appears in 1 contract
Samples: Supplemental Warrant Indenture (Bunker Hill Mining Corp.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxx XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Victory Square Technologies Inc. Exercise Price Payable: ((A) multiplied by $0.78, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. Mogo Inc. (the “Corporation”) AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire _____________ (A) Common Shares of Invictus MD Strategies Corp. Mogo Inc. Exercise Price Payable: _________________________________________________________ ((A) multiplied by $2.03, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture (Mogo Inc.)
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares or Common Shares and Incentive Warrants, as applicable of Invictus MD Strategies Tower One Wireless Corp. Exercise Price Payable: ((A) multiplied by $0. , subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Shares or Common Shares and Incentive Warrants, as applicable 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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 EXERCISE FORM TO: Invictus MD Strategies Corp. MGX Minerals Inc. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. MGX Minerals Inc. Exercise Price Payable: ((A) multiplied by $1.20, subject to adjustment) 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. Any capitalized term in this Warrant Certificate that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare Odyssey Trust Company 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd FloorXxxxx 0000, 000 0xx Xxxxxx X.X. Xxxxxxx, Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. VIBE GROWTH CORPORATION Exercise Price Payable: ((A) multiplied by $1.06, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare TSX Trust Company 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 EXERCISE FORM TO: Invictus MD Strategies Corp. SPONSORSONE INC. AND TO: Computershare Trust Company of Canada 3rd FloorTSX TRUST COMPANY 301 – 100 Xxxxxxxx Xxxxxx Xxxx Xxxxxxx, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: SPONSORSONE INC. 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. Any capitalized term in this Warrant Certificate that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare ENDEAVOR TRUST CORPORATION 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, SCHEDULE “B” EXERCISE FORM 000 Xxxxxxx Xxxxxx, XxxxxxxxxXxxxxxxxxx Xxx. Xxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) acquire: Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: The undersigned hereby exercises I3 INTERACTIVE INC. pursuant to the right of such holder to be issued, and hereby subscribes for, the Common Shares that are issuable pursuant to the exercise of such Warrants on the terms specified in such Warrant Certificate and in the Warrant IndentureIndenture for an aggregate exercise price of . 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 hereby represents, warrants and certifies as follows that (one check box (onlya), (b), (c) of the following must be checked):or
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Xxxx Data Solutions Inc. Exercise Price Payable: ((A) multiplied by (i) $0.35, if exercised prior to July 5, 2018, or (ii) $0.40 thereafter, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. AND TO: Computershare Trust Company of Canada SCHEDULE “B” EXERCISE FORM 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. Exercise Price Payable: adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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 EXERCISE FORM TO: Invictus MD Strategies Corp. MGX Minerals Inc. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, 0xx Xxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________(A) Common Shares of Invictus MD Strategies Corp. MGX Minerals Inc. Exercise Price Payable: ((A) multiplied by $1.15, subject to adjustment) 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. Any capitalized term in this Warrant Certificate that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. The undersigned represents, warrants and certifies as follows (one (only) of the following must be checked):
Appears in 1 contract
Samples: Warrant Indenture
REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Computershare 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). TO: Invictus MD Strategies Corp. Helius Medical Technologies, Inc. AND TO: Computershare Trust Company of Canada 3rd Floor, 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, XX Xxxxxxx Xxxxxxxx X0X 0X0 The undersigned holder of the Warrants evidenced by this the Warrant Certificate hereby exercises the right to acquire _____________ (A) Class A common shares (the “Common Shares Shares”) of Invictus MD Strategies Corp. Helius Medical Technologies, Inc. Exercise Price Payable: ((A) multiplied by $1.50, subject to adjustment) 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):
Appears in 1 contract
Samples: Warrant Indenture (Helius Medical Technologies, Inc.)