SCHEDULE A [Citation:[neutral citation] [Date of decision document]] 1 In the Matter of the Securities Legislation of [names of jurisdictions participating in this decision document (the Jurisdictions)] and In the Matter of The Mutual Reliance Review System for Exemptive Relief Applications and In the Matter of [name(s) of filer(s) and relevant parties, including definitions as required, collectively, the Filer] MRRS Decision Document Background The local securities regulatory authority or regulator (the Decision Maker) in each of the Jurisdictions has received an application from the Filer(s) for a decision under the securities legislation of the Jurisdictions (the Legislation) for [describe the requested relief (the Requested Relief) in words following the examples below - do not use statutory references - include defined terms as necessary: • an exemption from the dealer registration requirement and the prospectus requirements of the Legislation • a waiver from the valuation requirements of the Legislation • that the Filer is deemed to have ceased to be a reporting issuer] Under the Mutual Reliance Review System for Exemptive Relief Applications (a) the [name of the principal regulator] is the principal regulator for this application, and (b) this MRRS decision document evidences the decision of each Decision Maker. Interpretation Defined terms contained in National Instrument 14-101 Definitions have the same meaning in this decision unless they are defined in this decision. [add additional definitions here] 1 The citation and date of decision will be completed by staff after the opt-out period has expired
Representations This decision is based on the following facts represented by the Filer(s): [Insert material representations necessary to explain why the Decision Makers came to this decision and include the location of the Filer’s head office. Do not use statutory references. It may be appropriate to refer to national or multilateral instruments.] Decision Each of the Decision Makers is satisfied that the test contained in the Legislation that provides the Decision Maker with the jurisdiction to make the decision has been met. The decision of the Decision Makers under the Legislation is that the Requested Relief is granted provided that: [Insert numbered terms and conditions. These should be generic and without statutory references to the Legislation of the Jurisdictions where this application was filed If the effective date of any head of relief differs from the date of the decision document, state here. For example, designating an issuer to be a reporting issuer as of the closing of transaction] (Name(s) of Decision-Maker) (Title) (Name of Principal Regulator) (justify signature block) 2
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