55-102F2 - Insider Report [F Proposed - Lapsed]

An insider report filed in SEDI format shall contain the following information:

1. Name of reporting issuer

Provide the name of the issuer of the securities that are the subject of the insider report.  A separate report must be filed for each reporting issuer.  Choose the name of the reporting issuer from the list of one or more reporting issuers created previously in the insider’s profile.  If the name of the relevant reporting issuer does not appear in the list, the insider’s profile must be amended to add the name of the relevant reporting issuer before the insider report may be completed.

2. Amended report

Indicate whether the report is intended to amend information contained in a previous insider report filed in SEDI format.  If so, the amended report should contain all information required to be disclosed in the original report.

3. Type of security

For each position or transaction being reported, indicate the type of the relevant security or class of securities by selecting (A) Equity, (B) Debt or (C) Third Party Derivative.  This selection will determine the nature of the information to be reported in each case.  If the security is an option, warrant or other derivative security issued by the reporting issuer, select (A) Equity or (B) Debt based on the type of underlying security or underlying class of securities involved.

4. Designation of class of securities

Provide the designation of each security or class of securities that is the subject of the insider report.  For each security or class of securities,  (A) select the relevant designation from the list of designations shown, as reported by the reporting issuer or, (B) if the relevant designation is not provided in the issuer’s list, select the relevant designation from a master list provided by SEDI or, (C) if the relevant designation is not provided in the master list, select “Other” and provide the proper designation of the relevant security or class of securities in the field provided.

5. Balance of class of securities held (initial SEDI report only)

If the insider is filing an initial report of securities held on becoming an insider or is reporting a change in a security or class of securities not previously reported in SEDI format, provide the initial number or amount of securities held in the field provided for this purpose.  For debt securities, provide the aggregate nominal value of the securities held.

If the insider has previously filed a report in SEDI disclosing the balance of the security or class of securities held, the opening balance of securities held in the class of securities being reported is generated by the SEDI software application based on all previous reports filed in respect of the relevant class of securities.

6. Date of transaction

Provide the date of each transaction being reported using the “Day”, “Month” and “Year” fields provided for this purpose.  Provide the “trade date” not the “settlement date”.

7. Nature of transaction

Indicate the nature of each transaction being reported using the list of transaction types provided for this purpose.

8. Number/value of securities acquired

Disclose the number or value of securities acquired for each transaction involving an acquisition of securities.

9. Number/value of securities disposed of

Disclose the number or value of securities disposed of for each transaction involving a disposition of securities.

10. Unit price/exercise price

Disclose the price per security paid or received by the insider for each transaction being reported.  Do not reduce the price being reported to reflect the amount of any commission paid.  If the insider is acquiring or disposing of an option, warrant or other derivative security issued by the reporting issuer for consideration other than cash or property, report the exercise price, if any, instead of the price per security paid or received.  If the exercise price of the derivative security will adjust on one or more specified dates, provide the details of the adjustment terms in the “Additional Comments” field.

11. Currency

If the price paid or received is in a currency other than Canadian dollars, select the relevant currency from the list provided for this purpose.

12. New balance of class of securities held

After the number or value of securities acquired or disposed of has been provided in the applicable field, a new balance of the security or class of securities held will be generated automatically by SEDI.  If the amount reported by SEDI is not correct, the correct balance must be reported in the field provided for this purpose.  The insider should make all reasonable efforts to reconcile the balance reported by SEDI with the balance believed by the insider to be correct.  An incorrect balance may have resulted from an error in a previous insider report or from a failure to report a previous transaction.

13. Direct/indirect ownership, control or direction

If the insider is reporting a balance of securities held, indicate whether the securities are (A) beneficially owned directly, (B) beneficially owned indirectly or (C) controlled or directed.

14. Identity of registered holder of securities where ownership is indirect or where control or direction is exercised

Provide the name of the registered holder of the securities held if beneficial ownership of the securities is indirect or if control or direction is exercised over the securities.  If available, select the name of the registered holder from the list that may have been created in the insider’s profile.  If a list is not available, enter the full legal name of the registered holder in the field provided.

15. Additional comments

Provide any additional information required to fully understand the nature of the position(s) and/or trade(s) in the securities that are the subject of the report.  At the option of the insider, any other additional comments may be provided.  Indicate whether the comments are intended to be viewed by the public or are to be kept confidential by selecting public or private access, as applicable.  If the information disclosed is required to understand the nature of the position or transaction being reported, then public access must be provided.

Transactions In Third Party Derivatives

If the transaction being reported is the acquisition or disposition of an option or other derivative security issued by a person or company other than the reporting issuer, the following additional information must be disclosed, if applicable:

16. Designation of underlying security or class of securities

Provide the designation of the underlying security or class of securities to which the third party derivative security relates.  Select the relevant designation from the list of designations shown, as reported by the reporting issuer or, if the relevant designation of the underlying security is not provided in the issuer’s list, select the relevant designation of the underlying security from a master list provided by SEDI or, if the relevant designation is not provided in the master list, select “Other” and provide the proper designation of the underlying security or underlying class of securities in the field provided.

17. Conversion or exercise price of derivative security

Provide the conversion or exercise price of the third party derivative security by entering the amount in the field provided for this purpose.  If the conversion or exercise price is in a currency other than Canadian dollars, select the relevant currency from the list provided.

18. Date derivative security becomes exercisable

If the third party derivative security is not exercisable immediately, specify the date that the third party derivative security becomes exercisable using the “Day”, “Month” and “Year” fields provided.

19. Expiration date of derivative security

If the third party derivative security expires on a given date, specify the expiration date using the “Day”, “Month” and “Year” fields provided.

20. Amount of underlying securities

Disclose the number or value of the underlying securities that may be purchased or sold upon conversion or exercise of the third party derivative security or that otherwise determines the value of the third party derivative security.

21. Price of derivative securities

Disclose the premium or other amount paid or received by the insider in connection with the acquisition or disposition of the third party derivative security.  If the premium or other amount paid or received is in a currency other than Canadian dollars, select the relevant currency from the list provided.

Certification

The insider or the insider’s agent must certify that the information is true and complete in every respect.  In the case of an agent, the certification is based on the agent’s best knowledge, information and belief but the insider is still responsible for ensuring that the information filed by the agent is true and complete.  It is an offence to file information that, at the time and in the light of the circumstances in which it is given, contains a misrepresentation.

Notice - Collection and Use of Personal Information

The personal information prescribed by this form is collected on behalf of and used by the Securities Commissions set out below for purposes of the administration and enforcement of the insider trading provisions of the securities legislation in Alberta, British Columbia, Manitoba, Newfoundland, Nova Scotia, Ontario, Quebec and Saskatchewan. All of the information prescribed by this form, except any additional comments that the insider designates as “Private” under item 15 above, is made public pursuant to National Instrument 55-102 and Companion Policy 55-102CP and the securities legislation in each of the jurisdictions indicated above.  If you have any questions about the collection and use of this information, contact the Securities Commission(s) in the jurisdiction(s) in which the form is filed, at the address(es) set out below. 

Alberta Securities Commission
4th  Floor, 300-4th Avenue S.W.
Calgary, AB   T2P 3C4
Attention: Information Officer
Telephone: (403) 297-6454
Facsimile: (403) 297-6156

British Columbia Securities Commission
200- 865 Hornby Street
Vancouver, BC   V6Z 2H4
Attention: Supervisor, Insider Reporting
Telephone: (604) 899-6548 or
(800) 373-6393 (in B. C.)
Facsimile: (604) 899-6760

Manitoba Securities Commission
1130-405 Broadway
Winnipeg, MB  R3C 3L6
Attention: Assistant Counsel
Telephone: (204) 945-3625
Facsimile: (204) 945-4508

Securities Commission of Newfoundland
P.O. Box 8700
2nd Floor, West Block
Confederation Building
75 O’Leary Avenue
St. John’s, NFLD  A1B 4J6
Attention: Director of Securities
Telephone: (709) 729-4189
Facsimile: (709) 729-6187
 
Nova Scotia Securities Commission
2nd Floor, Joseph Howe Building
1690 Hollis Street
P.O. Box 458
Halifax, NS  B3J 3J9
Attention: FOI Officer
Telephone: (902) 424-7768
Facsimile: (902) 424-4625

Ontario Securities Commission
Suite 1903, Box 55
20 Queen Street West
Toronto, ON
M5H 3S8
Attention: FOI Coordinator
Telephone: (416) 593-8314
Facsimile: (416) 593-8122
 
Commission des valeurs mobilières du Québec
Stock Exchange Tower
P.O. Box 246, 22nd Floor
800 Victoria Square
Montréal, PQ   H4Z 1G3
Attention: The Person in Charge of Access to Documents or of Protection of Personal Information
Telephone: (514) 940-2150 or
(800) 361-5072 (in Quebec)
Facsimile: (514) 864-6381

Saskatchewan Securities Commission
800-1920 Board Street
Regina, SK  S4P 3V7
Attention: Deputy Director, Registration
Telephone: (306) 787-5842
Facsimile: (306) 787-5899