EX-5 3 dex5.htm FORM OF SHARE CERTIFICATE FOR COMMON STOCK

The following abbreviations shall be construed as though the words set forth below opposite each abbreviation were written out in full where such abbreviation appears:

TEN COM |  | - as tenants in common |  |
TEN ENT |  | - as tenants by the entireties |  |
JT TEN |  | - as joint tenants with rights of survivorship and not as tenants in common |  |
(Name) CUST (Name) UNIF |  | - (Name) as Custodian for (Name) under the |  |
GIFT MIN ACT (State) |  | (State) Uniform Gifts to Minors Act |  |
Additional abbreviations may also be used though not in the above list. |  |

* Please insert Social Insurance, Tax Identification, or other identifying number of transferee. |  | __________________________________

For value received the undersigned hereby sells, assigns and transfers unto

Insert name and address of transferee

______________________________________________________________________________________________________ Shares represented by this certificate and does hereby irrevocably constitute and appoint

_________________________________________________________________________________________________ the attorney of the undersigned to transfer the said shares on the books of the Company with full power of substitution in the premises.

DATED: ________________________ |  | _______________________________ |  | _______________________________
|  | Signature of Shareholder |  | Signature of Guarantor

Signature Guarantee:

The signature on this assignment must correspond with the name as written upon the face of the certificate(s), in every particular, without alteration or enlargement, or any change whatsoever and must be guaranteed by a major Canadian Schedule I chartered bank, a major trust company in Canada or a member of an acceptable Medallion Signature Guarantee Program (STAMP, SEMP, MSP). The Guarantor must affix a stamp bearing the actual words “Signature Guaranteed”.

In the USA, signature guarantees must be done by members of a “Medallion Signature Guarantee Program” only.

Signature guarantees are not accepted from Treasury Branches, Credit Unions or Caisses Populaires unless they are members of the Stamp Medallion Program.

Computershare’s Privacy Notice:

In the course of providing services to you and our corporate clients, Computershare receives non-public personal information about you - your name, address, social insurance number, securities holdings, transactions, etc. We use this to administer your account, to better serve your and our clients’ needs and for other lawful purposes. We have prepared a Privacy Code to tell you more about our information practices and how your privacy is protected. It is available at our website, computershare.com, or by writing us at 100 University Avenue, Toronto, Ontario, M5J 2Y1. *You are required to provide your SIN if you will receive income on these securities. We will use this number for income reporting. Computershare may also ask for your SIN as an identification-security measure if you call or write to request service on your account; however you may decline this usage.