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Securities Law

Form 61 - Quarterly report [F - Rescinded]

Published Date: 1995-04-21
Effective Date: 1995-07-31
Rescinded Date: 2001-01-01

THE FOLLOWING TEXT IS FOR INFORMATIONAL PURPOSES ONLY.

 

FORM 61

Securities Act

QUARTERLY REPORT

 

INSTRUCTIONS

This report is to be filed by Exchange Issuers within 60 days of the end of their first, second and third fiscal quarters and within 140 days of the end of their fourth fiscal quarter. Three schedules (typed) are to be attached to this report as follows:

SCHEDULE A: FINANCIAL INFORMATION

Financial information prepared in accordance with generally accepted accounting principles for the fiscal year-to-date, with comparative information for the corresponding period of the preceding fiscal year. This financial information should consist of the following:

For the first, second and third fiscal quarters:

An interim financial report presented in accordance with Section 1750 of the C.I.C.A. Handbook. This should include a summary income statement (or a statement of deferred costs) and a statement of changes in financial position. A summary balance sheet is also to be provided.

For the fourth fiscal quarter (year end):

Annual audited financial statements.

SCHEDULE B: SUPPLEMENTARY INFORMATION

The supplementary information set out below is to be provided when not included in Schedule A.

  1. For the current fiscal year-to-date:

    Breakdown, by major category, of those expenditures and costs which are included in the deferred costs, exploration and development expenses, cost of sales and general and administrative expenses set out in Schedule A. State the aggregate amount of expenditures made to parties not at arm's length from the issuer.

  2. For the quarter under review:

    (a) Summary of securities issued during the period, including date of issue, type of security (common shares, convertible debentures, etc.), type of issue (private placement, public offering, exercise of warrants, etc.) number, price, total proceeds, type of consideration (cash, property, etc.) and commission paid.

    (b) Summary of options granted, including date, number, name of optionee, exercise price and expiry date.

  3. As at the end of the quarter:

    (a) Particulars of authorized capital and summary of shares issued and outstanding.

    (b) Summary of options, warrants and convertible securities outstanding, including number or amount, exercise or conversion price and expiry date.

    (c) Total number of shares in escrow or subject to a pooling agreement.

    (d) List of directors.

SCHEDULE C: MANAGEMENT DISCUSSION

Review of operations in the quarter under review and up to the date of this report, including brief details of any significant event or transaction which occurred during the period. The following list can be used as a guide but is not exhaustive:

Acquisition or abandonment of resource properties, acquisition of fixed assets, financings and use of proceeds, management changes, material contracts, material expenditures, transactions with related parties, legal proceedings, contingent liabilities, default under debt or other contractual obligations, special resolutions passed by shareholders.

Specifically, the management discussion must include:

(a) disclosure of and reasons for any material differences in the actual use of proceeds from the previous disclosure by the issuer regarding its intended use of proceeds; and

(b) a brief summary of the investor relations activities undertaken by or on behalf of the issuer during the quarter and disclosure of the material terms of any investor relation arrangements or contracts entered into by the issuer during the quarter.

______________________________________________________

Freedom of Information and Protection of Privacy Act

The personal information requested on this form is collected under the authority of and used for the purpose of administering the Securities Act. Questions about the collection or use of this information can be directed to the Supervisor, Statutory Filings (604-899-6729), 200 - 865 Hornby Street, Vancouver, British Columbia V6Z 2H4.

Toll Free in British Columbia 1-800-373-6393

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ISSUER DETAILS

NAME OF ISSUER               FOR QUARTER ENDED          DATE OF REPORT
                                                                                                                   Y M D
                                                                                                       [__ __][__ __][__ __]

________________________________________________________

ISSUER'S ADDRESS

________________________________________________________

CITY PROVINCE       POSTAL CODE      ISSUER FAX NO.    ISSUER TELEPHONE NO.

                                    [__ __ __] [__ __ __]

_________________________________________________________

CONTACT PERSON     CONTACT'S POSITION     CONTACT TELEPHONE NO.

__________________________________________________________

CERTIFICATE

The three schedules required to complete this Quarterly Report are attached and the disclosure contained therein has been approved by the Board of Directors. A copy of this Quarterly Report will be provided to any shareholder who requests it.

____________________________________________________________

DIRECTOR'S SIGNATURE        PRINT FULL NAME                 DATE SIGNED
                                                                                                                      Y M D
                                                                                                        [__ __][__ __][__ __]

____________________________________________________________

DIRECTOR'S SIGNATURE         PRINT FULL NAME                DATE SIGNED
                                                                                                                     Y M D
                                                                                                         [__ __][__ __][__ __]

____________________________________________________________

FIN 2061 Rev. 98/5/19