Personal Information Form And Authorization Of Indirect Collection, Use And Disclosure Of Personal Information (Page 4 of 4) in pdf

Personal Information Form And Authorization Of Indirect Collection, Use And Disclosure Of Personal Information Page 4

Telephone: 902-424-7768

Facsimile: 902-424-4625

Prince Edward Island Securities Office

95 Rochford Street, 4

Floor Shaw Building

P.O. Box 2000

Charlottetown, Prince Edward Island C1A 7N8

Telephone: 902-368-4569

Facsimile: 902-368-5283

Government of Newfoundland and Labrador

Financial Services Regulation Division

P.O. Box 8700

Confederation Building

Floor, West Block

Prince Philip Drive

St. John’s, NFLD A1B 4J6

Attention: Director of Securities

Telephone: 709-729-4189

Facsimile: 709-729-6187

Government of Yukon

Department of Community Services

Corporate Affairs, Yukon Securities Office

307 Black Street, 1

Floor

PO Box 2703 (C-6)

Whitehorse, Yukon Y1A 2C6

Telephone: 867-667-5466

Facsimile: 867-393-6251

Government of the Northwest Territories

Office of the Superintendent of Securities

P.O. Box 1320

Yellowknife, NT X1A 2L9

Attention: Deputy Superintendent, Legal & Enforcement

Telephone: 867-920-8984

Facsimile: 867-873-0243

Government of Nunavut

Department of Justice

Legal Registries Division

P.O. Box 1000, Station 570

Floor, Brown Building

Iqaluit, Nunavut X0A 0H0

Telephone: 867-975-6590

Facsimile: 867-975-6594

Personal Information Form And Authorization Of Indirect Collection, Use And Disclosure Of Personal Information Page 4