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National Instrument 54-101 54-101F9 Undertaking
Note: Terms used in this Form have the meanings given to them in National Instrument 54-101. The use of this Form
is referenced in sections 2.5, 6.1 and 6.2 of National Instrument 54-101.
I ________________________________________________________________________________
(Full Residence Address) _____________________________________________________________
(If this undertaking is made on behalf of a body corporate, set out the full legal name of the body corporate, position of person signing and
address for service of the body corporate).
SOLEMNLY DECLARE AND UNDERTAKE THAT:
1 I require a list in the required format of the non-objecting beneficial owners of securities of [insert name of the
reporting issuer] on whose behalf intermediaries hold securities (a NOBO list), as shown on the records of the
intermediaries.
Initial box if reporting issuer
2 I undertake that the information set out on the NOBO list will be used only in connection with matters relating to the
affairs of the reporting issuer.
Initial box if person or company other than the reporting issuer
2 I undertake that the information set out on the NOBO list will be used only for one or more of the following purposes:
(a
) sending security holder materials direct
ly to NOBOs in accordance with National Instrument 54-101;
(b) an effort to influence the voting of security holders of the
reporting issuer; or
(c) an offer to acquire securities of the reporting issuer.
3 I undertake that,
except as permitted under National Instrument 54-101, the NOBO list will not be used to send security
holder materials to those NOBOs that are identified on the NOBO list as having chosen not to receive the materials,
and that the materials sent shall include the following statement:
These security holder materials are being sent to both registered and non-registered owners of the securities. If you are
a non-registered owner, and the issuer or its agent has sent these materials directly to you, your name and address and
information about your holdings of securities, have been obtained in accordance with applicable securities regulatory
requirements from the intermediary holding on your behalf.
4 I acknowledge that it is a contravention of the law to use a list for purposes other than in connection with one or more
of the following:
(a
) Sending security holder materi
als to NOBOs in accordance with National Instrument 54-101;
(b) An effort to influence the voting of security holders of t
he reporting issuer; or
(c) An offer to acquire securities of the reporting issuer.
5 I declare that I
(or the person or company I am using to make this request) have the technological capacity to receive
the NOBO list.
___________________________________________________
Signature
__________________________________________________
Name of person signing (please print)
__________________________________________________
Date