4 - Distribution Requirements

[Print]

45-505F1 Notice Of Intention To Rely On BC Instrument 45-505 [F]
Published December 22, 2000
Effective January 1, 2001
View Microsoft Word version New window

This is the form required under section 3(a) of BC Instrument 45-505

BC Form 45-505F1

NOTICE OF INTENTION TO RELY ON BC INSTRUMENT 45-505

1. Name, address and telephone number of each eligible pooled fund that intends to rely on BC Instrument 45-505.

______________________________________
Name(s) of eligible pooled fund(s)

______________________________________
Address

( )__________________________________
Telephone Number

2. Name, address and telephone number of the eligible portfolio manager of the eligible pooled fund(s).

_______________________________________
Name of eligible portfolio manager

_______________________________________
Address

( )___________________________________
Telephone Number

3. The eligible pooled fund(s):

Please check

(a) has (have) filed the Forms 20 required to be filed under section 139 of the Rules for all distributions by the fund(s) in British Columbia during the 6 year period immediately preceding the date of this Form, and

(b) has (have) paid the fees for those distributions as prescribed under Item 26 of section 22 of the Securities Regulation, B.C. Reg. 196/97, as amended by B.C. Reg. 388/2000,

(c) attach(es) a completed Form 45-505F2 (other than paragraph 8 of that Form) for distributions by the fund(s) in British Columbia during the 6 year period immediately preceding the date of this Form for which Forms 20 have not been filed, and

(d) attach(es) a cheque payable to the British Columbia Securities Commission in the amount that equals either of:

(i) 0.01% of the total dollar value of additional assets under management invested in the fund(s) under those distributions by purchasers resident in British Columbia;

(ii) 0.01% of [(the total proceeds realized by the fund(s) under those distributions) x (the current percentage of the assets of the fund(s) held to the benefit of residents of British Columbia)].

4. The eligible pooled fund(s) is (are) eligible to file reports under BC Instrument 45-505. The undersigned hereby certifies, to the best of his/her knowledge, information and belief, that the statements made in this report are true and correct.

DATED at Vancouver, British Columbia this day of , 200.

________________________________________________

Name of eligible portfolio manager

(please print)

on behalf of the

________________________________________________
Name(s) of eligible pooled fund(s)

(please print)

Per:

____________________________________
Signature of authorized signatory

____________________________________
Name and office of authorized signatory

(please print)

IT IS AN OFFENCE FOR A PERSON TO MAKE A STATEMENT IN A RECORD REQUIRED TO BE FILED OR PROVIDED UNDER THE SECURITIES ACT OR SECURITIES RULES THAT, AT THE TIME AND IN LIGHT OF THE CIRCUMSTANCES UNDER WHICH IT IS MADE, IS A MISREPRESENTATION.