81-903F - Report Required Under Section 126 of the Act [F - Rescinded]

This is the form required under section 126 of the Securities Act.

BC FORM 81-903F (Previously Form 38)

Securities Act

REPORT REQUIRED UNDER SECTION 126 OF THE ACT

Name of the mutual fund for which the mutual fund manager provides services
and advice_________________________________________________________
Name of the management company _____________________________________
Date of the transaction _______________________________________________
Category of the transaction (Instruction 1) ________________________________
Parties to the transaction ______________________________________________
Nature of the transaction (Instruction 2) __________________________________

The undersigned hereby certifies that the information given in this report is true and complete in every respect.

___________________________________ ___________________________________
Date of Report Name of Management Company

By _________________________________
Signature

____________________________________
Official Capacity


Instruction 1

Categorize each transaction as being a transaction of purchase and sale of securities between the mutual fund and a related person*, a transaction or purchase and sale of securities resulting in a related person receiving a fee, a loan between the mutual fund and a related person or a transaction to which the mutual fund and a related person of the mutual fund are joint participants.

Instruction 2

Where the transaction is categorized as a purchase or sale of securities between the mutual fund and a related person, state the issuer of the securities purchased or sold, the class or designation of the securities, the amount or number of securities and the consideration.

Where the transaction is categorized as a purchase or sale of securities resulting in a related person receiving a fee, state the name of the issuer of the securities purchased or sold, the class or designation of the securities, the amount or number of the securities, the consideration, the name of the related person receiving a fee, the name of the person that paid the fee to the related person and the amount of the fee received by the related person.

Where the transaction is categorized as a loan between the mutual fund and a related person, state the name of the lender, the name of the borrower, the amount of money loaned, the terms of the loan and the purpose of the loan.

Where the transaction is categorized as one to which the mutual fund and one or more of its related persons are joint participants, state terms of participation and the purpose of the transaction.



* "Person" includes "company" (Interpretation Act, R.S.B.C 1996, c. 238, s. 29).