Unofficial Consolidation: Form 45-106F17 Notice of Specified Key Events

Unofficial Consolidation: Form 45-106F17 Notice of Specified Key Events

Forms

Ontario Securities Commission

Form 45-106F17

Unofficial consolidation current to 2016-04-30

This document is not an official statement of law or policy and should be used for reference purposes only.

Form 45-106F17
Notice of Specified Key Events

This is the form required under subsection 2.9(17.20) of National Instrument 45-106 Prospectus Exemptions (NI 45-106) in New Brunswick, Nova Scotia and Ontario to make available notice of specified key events to holders of securities acquired under subsection 2.9(2.1) of NI 45-106.

  1. Issuer Name and Address

Provide the following information.

Full legal name

 

 

 

 

 

 

 

 

 

Street address

 

Province/State

 

 

Municipality

 

Postal code/Zip code

 

 

Website

 

Country

 

 

 

  1. Specified Key Event

Provide the following information.

The event, as described in section 3, is: [Select one or more type of event from the list below]

(a)          a discontinuation of the issuer’s business

(b)          a change in the issuer’s industry

(c)          a change of control of the issuer

Date on which the event occurred (yyyy/mm/dd):

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  1. Event Description

Provide a brief description of the event identified in section 2.

  1. Contact Person

Provide the following information for a person at the issuer who can be contacted regarding the event described in section 3.

Name

 

Title

 

 

Email address

 

Telephone number

 

 

 

 

 

 

 

                           

 

Date of notice (yyyy/mm/dd):

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