Request for Financial Statements

In accordance with National Instrument 51-102 – Continuous Disclosure Obligations, shareholders may elect annually to have their names added to the issuer’s Supplemental Mailing List for Interim Financial Statements with MD&A.

I HEREBY CERTIFY that I am a Shareholder of the Company, and as such, request that you provide me with the following:*
- Interim Financial Statements with MD&A
- Annual Financial Statements with MD&A
First Name*
Last Name
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Street Address City State / Province / Region ZIP / Postal Code Country
Preferred method of communication:*
- Email
- Mail
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