EX-99.4 5 d922350dex994.htm EX-99.4

EX-99.4

Exhibit 99.4

ALAMOS GOLD INC. Please return completed form to: Computershare 8th Floor, 100 University Avenue Toronto, Ontario M5J 2Y1 +

				Interim Financial Statements				Annual Financial Statements
		¨		Mark this box if you would like to receive Interim Financial Statements and related MD&A by mail.		¨		Mark this box if you would like to receive the Annual Financial Statements and related MD&A by mail.

Financial Statements Request Form

Under securities regulations, a reporting issuer must send annually a form to holders to request the Interim Financial Statements and MD&A and/or the Annual Financial Statements and MD&A. If you would like to receive the report(s) by mail, please make your selection and return to the address as noted or register online at www.computershare.com/mailinglist.

Alternatively, you may choose to access the report(s) online at www.sedar.com or http://www.alamosgold.com/investors/reports-and-financials/default.aspx

Computershare will use the information collected solely for the mailing of such financial statements. You may view Computershare’s Privacy Code at www.computershare.com/privacy or by requesting that we mail you a copy.

Please place my name on your financial statements mailing list.

Name

Apt. Street Number Street Name

City																																														Prov. / State								Postal Code / Zip Code
																																																						0		0		0		0		0		0

¢   BJAQ		5 1 E T N N		+
51ETNN01