TORONTO STOCK EXCHANGE COMPANY MANUAL
Form 11A – Price Protection Form
Issuer Name:
Date: Stock Symbol:
1. Indicate the market price of the issuer’s securities (5-day VWAP) as of the date hereof.
2. Will the issuer’s securities be issued or made issuable to insiders pursuant to the private placement? If so, indicate the maximum number of securities issued or made issuable to insiders or the maximum amount that insiders will subscribe for in dollar terms (in absolute terms or as a percentage of the private placement). Failure to provide details regarding insider participation in a private placement may result in the withdrawal of price protection granted by TSX for any insiders participating in the relevant private placement.
3. As of the day hereof, is there material undisclosed information regarding the issuer? If so, indicate the nature of the information and the anticipated date on which such information is expected to be disclosed to the public. TSX may refuse to grant price protection based on a market price which does not reflect material undisclosed information.
4. If known, indicate the price at which the securities are proposed to be issued or made issuable. In the case of warrants or other convertible securities, indicate the proposed exercise or conversion price.
5. If known, provide details as to the anticipated size and structure of the private placement.