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Lost Certificate Notice

Please provide all relevant information.

* indicates the required fields

SHAREHOLDER INFORMATION
Registration Address (If address has changed since the certificate was issued, please include current and former address)
Previous Address
LOSS DETAILS

By completing and submitting this form, you confirm that the above referenced share certificate(s) have been lost, mislaid, stolen or destroyed. Upon submission of this form, TSX Trust will place a Stop on the certificate(s).

The requirements, procedure and fees to replace the certificate(s) will be sent by email.