Common use of REASON FOR TRANSFER – FOR US RESIDENTS ONLY Clause in Contracts

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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: FLOWER ONE HOLDINGS INC. AND TO: ODYSSEY TRUST COMPANY The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.36, 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. 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 2 contracts

Samples: webfiles.thecse.com, webfiles.thecse.com

AutoNDA by SimpleDocs

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS INC. AND TO: ODYSSEY TRUST COMPANY The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.362.60, 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. 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 2 contracts

Samples: webfiles.thecse.com, webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS ACREAGE HOLDINGS, INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________ (A) Common Floating Shares of Flower One Holdings Acreage Holdings, Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.364.00, 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 Floating Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS INC. CX One Inc. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company 0000, 000 0xx Xxx XX Calgary, AB T2P 3C4 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) acquire: Common Shares of Flower CX One Holdings Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.36, subject pursuant to adjustment) The undersigned hereby exercises 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. 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 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: sec.report

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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). SCHEDULE “B” EXERCISE FORM‌ TO: FLOWER ONE HOLDINGS I3 INTERACTIVE INC. AND TO: ODYSSEY ENDEAVOR TRUST COMPANY CORPORATION 000 Xxxxxxxxxx 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 Flower One Holdings Inc. (the “Company”)I3 INTERACTIVE INC. Exercise Price Payable: ((A) multiplied by $0.36, subject pursuant to adjustment) The undersigned hereby exercises 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. 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 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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" EXERCISE FORM‌ FORM TO: FLOWER ONE HERITAGE CANNABIS HOLDINGS INCCORP. AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Heritage Cannabis Holdings Inc. (the “Company”). Corp. Exercise Price Payable: _ ((A) multiplied by $0.360.21, 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. 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS BRIGHT MINDS BIOSCIENCES INC. AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Bright Minds Biosciences Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.369.46, 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

Samples: sedar-filings-backup.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS INCARGO LIVING SOILS CORP. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company 350 – 000 Xxxxxxxxx Xxxxxx Xxxxxxxxx, XX X0X 0X0 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Warrant Shares of Flower One Holdings Inc. (the “Company”). Argo Living Soils Corp. Exercise Price Payable: ((A) multiplied by $0.360.35, subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Warrant 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 Warrant 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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: StillCanna Inc.‌ SCHEDULE “B” EXERCISE FORM‌ TO: FLOWER ONE HOLDINGS INC. FORM AND TO: ODYSSEY TRUST COMPANY National Securities Administrators Ltd. 000 Xxxxxx 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 Flower One Holdings StillCanna Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.361.73, 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. 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: www.sativawebsites.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ TO: FLOWER ONE HOLDINGS ACREAGE HOLDINGS, INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________ (A) Common Subordinate Voting Shares of Flower One Holdings Acreage Holdings, Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.365.80, subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Subordinate Voting 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 Subordinate Voting Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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 (Acreage Holdings, Inc.)

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS INC. VIBE GROWTH CORPORATION AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company Xxxxx 0000, 000 0xx Xxxxxx X.X. 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 Flower One Holdings Inc. (the “Company”). VIBE GROWTH CORPORATION Exercise Price Payable: ((A) multiplied by $0.361.06, 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. 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS INC. Bunker Hill Mining Corp.. (the “Corporation”) AND TO: ODYSSEY TRUST COMPANY Capital Transfer Agency ULC [B/P address] The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________ (A) Common Shares of Flower One Holdings Inc. (the “Company”). Bunker Hill Mining Corp. Exercise Price Payable: ((A) multiplied by $0.360.37, 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. 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 (Bunker Hill Mining Corp.)

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey Endeavor Trust 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 FORM TO: FLOWER ONE HOLDINGS INC. NeonMind Biosciences Inc. AND TO: ODYSSEY TRUST COMPANY Endeavor Trust Corporation Suite 702 – 000 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 Flower One Holdings NeonMind Biosciences Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.360.20, 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS INC. VIBE GROWTH CORPORATION AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company Xxxxx 0000, 000 0xx Xxxxxx X.X. Calgary, Alberta T2P 3C4 The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”). VIBE GROWTH CORPORATION Exercise Price Payable: ((A) multiplied by $0.361.06, 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. 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: sedar-filings-backup.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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” Schedule B EXERCISE FORM‌ TO: FLOWER ONE HOLDINGS SPONSORSONE INC. AND TO: ODYSSEY TSX TRUST COMPANY 301 – 100 Xxxxxxxx Xxxxxx Xxxx 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 Flower One Holdings Inc. (the “Company”)SPONSORSONE INC. Exercise Price Payable: ((A) multiplied by $0.360.30, 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: sedar-filings-backup.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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: MGX Minerals Inc. SCHEDULE “B” EXERCISE FORM‌ TO: FLOWER ONE HOLDINGS INC. FORM AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada (insert address) The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings MGX Minerals Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.360.20, 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, Odyssey 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" EXERCISE FORM‌ FORM TO: FLOWER ONE HERITAGE CANNABIS HOLDINGS INCCORP. AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Heritage Cannabis Holdings Inc. (the “Company”). Corp. Exercise Price Payable: _ ((A) multiplied by $0.360.70, 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. 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS ACREAGE HOLDINGS, INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Fixed Shares of Flower One Holdings Acreage Holdings, Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.364.00, 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 Fixed Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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: sedar-filings.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS RUBICON ORGANICS INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Rubicon Organics Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.363.50, 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. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS BRIGHT MINDS BIOSCIENCES INC. AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Bright Minds Biosciences Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.361.76, 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, 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). SCHEDULE "B" EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS INC. INNOCAN PHARMA CORPORATION AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company 1230, 000 0xx Xxx 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 Flower One Holdings Inc. (the “Company”). INNOCAN PHARMA CORPORATION Exercise Price Payable: ((A) multiplied by $0.360.25, 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. Any capitalized term in this Warrant Certificate Exercise Form 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS INC. Silver Viper Minerals Corp. (the "Corporation") AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”). Silver Viper Minerals Corp. Exercise Price Payable: ((A) multiplied by $0.360.50, 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. 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: www.otcmarkets.com

AutoNDA by SimpleDocs

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey the Warrant Agent 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 FORM TO: FLOWER ONE HOLDINGS INCPURE EXTRACTS TECHNOLOGIES CORP. AND TO: ODYSSEY TRUST COMPANY AST Trust Company (Canada) The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”). Pure Extracts Technologies Corp. Exercise Price Payable: ((A) multiplied by $0.360.65, 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. 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: Pure Extracts Technologies Corp

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS ICANIC BRANDS COMPANY INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company, as Warrant Agent The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Icanic Brands Company Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.360.15, 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. 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, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS SILVERCREST METALS INC. AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________ (A) Common Shares of Flower One Holdings SilverCrest Metals Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.361.45, 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. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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 (SilverCrest Metals Inc.)

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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). LEGAL*54381978.3 SCHEDULE "B" EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS LABRADOR URANIUM INC. AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”)LABRADOR URANIUM INC. Exercise Price Payable: ((A) multiplied by $0.361.05, 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. 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: sedar-filings-backup.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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 FORM TO: FLOWER ONE THE GREEN ORGANIC DUTCHMAN HOLDINGS INCLTD. AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One The Green Organic Dutchman Holdings Inc. (the “Company”). Ltd. Exercise Price Payable: ((A) multiplied by $0.369.50, 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. 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: sedar-filings-backup.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS ACREAGE HOLDINGS, INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire ____________ (A) Common Fixed Shares of Flower One Holdings Acreage Holdings, Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.364.00, 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 Fixed Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS INC. GENERATION MINING LIMITED AND TO: ODYSSEY TRUST COMPANY TSX Trust Company (insert address) The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”). Generation Mining Limited Exercise Price Payable: ((A) multiplied by $0.360.45, 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. 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, Odyssey 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 FORM TO: FLOWER ONE HOLDINGS INC. AND TO: ODYSSEY TRUST COMPANY The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.361.55, 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. 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ TO: FLOWER ONE HOLDINGS AVICANNA INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Avicanna Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.361.20, 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 herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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: ir.avicanna.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS ACREAGE HOLDINGS, INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Subordinate Voting Shares of Flower One Holdings Acreage Holdings, Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.365.80, subject to adjustment) The undersigned hereby exercises the right of such holder to be issued, and hereby subscribes for, Common Subordinate Voting 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 Subordinate Voting Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS CLOUDMD SOFTWARE & SERVICES INC. AND TO: ODYSSEY TRUST COMPANY Endeavor Trust Corporation Xxxxx 000, 000 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 Flower One Holdings Inc. (the “Company”)CLOUDMD SOFTWARE & SERVICES INC. Exercise Price Payable: ((A) multiplied by $0.361.00, 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. 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: Cloudmd Software

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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: FLOWER ONE HOLDINGS INC. Xxxx Data Solutions Inc. SCHEDULE B EXERCISE FORM AND TO: ODYSSEY TRUST COMPANY Computershare Trust Company of Canada (insert address) The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings Xxxx Data Solutions Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by (i) $0.360.35, 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. 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: webfiles.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, 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). SCHEDULE “B” EXERCISE FORM‌ FORM TO: FLOWER ONE HOLDINGS ACREAGE HOLDINGS, INC. AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Floating Shares of Flower One Holdings Acreage Holdings, Inc. (the “Company”). Total Exercise Price Payable: ((A) multiplied by $0.364.00, 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 Floating Shares received on exercise may be subject to restrictions on resale under applicable securities legislation. Any capitalized term in this Warrant Certificate herein that is not otherwise defined herein, shall have the meaning ascribed thereto in the Warrant Indenture. 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: sedar-filings.thecse.com

REASON FOR TRANSFER – FOR US RESIDENTS ONLY. Consistent with US IRS regulations, Odyssey 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: VEXT Science, Inc. SCHEDULE “B” EXERCISE FORM‌ TO: FLOWER ONE HOLDINGS INC. FORM AND TO: ODYSSEY TRUST COMPANY Odyssey Trust Company The undersigned holder of the Warrants evidenced by this Warrant Certificate hereby exercises the right to acquire (A) Common Shares of Flower One Holdings VEXT Science, Inc. (the “Company”). Exercise Price Payable: ((A) multiplied by $0.360.45, 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. 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: webfiles.thecse.com

Time is Money Join Law Insider Premium to draft better contracts faster.