Common use of Collection of Personal Information Clause in Contracts

Collection of Personal Information. The Subscriber hereby acknowledges and understands that: The information provided by the Subscriber on the Face Page identifying the name, address and telephone number of the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:

Appears in 2 contracts

Samples: proofcapital.ca, proofcapital.ca

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Collection of Personal Information. The By executing this Subscription Agreement, the Subscriber hereby acknowledges consents to the collection, use and understands that: The disclosure of the personal information provided herein and other personal information provided by the Subscriber or collected by the Corporation or its agents as reasonably necessary in connection with the Subscriber's subscription for the Subscribed Shares (collectively, "personal information") as follows: (a) the Corporation may use personal information and disclose personal information to intermediaries such as the Corporation's legal counsel and withholding and/or transfer agents for the purposes of determining the Subscriber's eligibility to invest in the Subscribed Shares and for managing and administering the Subscriber's investment in the Subscribed Shares; (b) if the Subscriber purchased securities through a registered dealer, the Corporation may disclose and collect such personal information relating to the Subscriber's holding of the Subscribed Shares to and from the dealer; (c) the Corporation and its agents may use the Subscriber's social insurance number for income reporting purposes in accordance with applicable law; (d) the Corporation, its agents and advisors, may each collect, use and disclose personal information for the purposes of meeting legal, regulatory, self-regulatory, security and audit requirements (including any applicable tax, securities, money laundering or anti-terrorism legislation, rules or regulations) and as otherwise permitted or required by law, which disclosures may include disclosures to tax, securities or other regulatory or self-regulatory authorities in Canada and/or in foreign jurisdictions, if applicable, in connection with the regulatory oversight mandate of such authorities; (e) the Corporation and its agents and advisors may use personal information and disclose personal information to parties connected with the proposed or actual transfer, sale, assignment, merger or amalgamation of the Corporation or its business or assets or similar transactions, for the purpose of permitting such parties to evaluate and/or proceed with and complete such transaction. Purchasers, assignees and successors of the Corporation or its business or assets may collect, use and disclose personal information as described in this Subscription Agreement. The Subscriber acknowledges that the Corporation's agents or intermediaries may be located outside of Canada, and personal information may be transferred and/or processed outside of Canada for the purposes described above, and that measures the Issuer may use to protect personal information while handled by agents, intermediaries or other third parties on its behalf, and personal information otherwise disclosed or transferred outside of Canada for the Face Page identifying purposes described above, are subject to legal requirements in foreign countries applicable to Issuer or such third parties, for example lawful requirements to disclose personal information to government authorities in those countries. If the Subscriber is resident in, or otherwise subject to the applicable securities legislation of Ontario, the Subscriber acknowledges (i) the delivery to the Ontario Securities Commission of the Subscriber's full name, residential address and telephone number, the number and type of securities purchased by the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawstotal purchase price, the number of Units being purchased hereunder exemption relied on, and the Subscription Amount as well as the Closing Date and the exemption date of distribution, (ii) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being collected indirectly collected by such the Ontario Securities Regulators Commission under the authority granted under Securities Laws. This to it in securities legislation, (iii) that such information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario, and may be disclosed (iv) that the Administrative Assistant to the public by Director of Corporate Finance at the Ontario Securities Commission, Sxxxx 0000, Xxx 00, 20 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, telephone (000) 000-0000, can be contacted to answer questions about the Ontario Securities Commission's indirect collection of such Securities Regulators in accordance with securities legislationinformation. Each The Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Ontario Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:Commission.

Appears in 2 contracts

Samples: Rights Agreement (Apollo Gold Corp), Rights Agreement (Apollo Gold Corp)

Collection of Personal Information. This Subscription Agreement requires the Subscriber to provide certain personal information to the Corporation. Such information is being collected by the Corporation for the purposes of completing the Offering, which includes, without limitation, determining the Subscriber’s eligibility to purchase the Securities under applicable securities legislation, preparing and registering certificates (or other evidence of subscription) representing the Common Shares and Warrants to be issued to the Subscriber and completing filings required by taxation authorities and any stock exchange or securities regulatory authority. Securities regulatory authorities in each of the provinces of Canada have been granted the authority to indirectly collect this personal information pursuant to securities legislation and this personal information is also being collected for the purpose of administration and enforcement of securities legislation. The Subscriber hereby acknowledges and understands that: The consents to the collection, use, and disclosure of certain personal information by securities regulatory authorities in Canada. If the Subscriber is resident in or otherwise subject to the securities laws applicable in another province of Canada, the information provided by the Subscriber on the Face Page first page of this Subscription Agreement identifying the name, address and telephone number of the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder and the Subscription Amount subscription price, as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units Securities will be disclosed to the Securities Regulatorsapplicable securities regulatory authority, and such information is being indirectly collected by such Securities Regulators securities regulatory authority under the authority granted to it under Securities Lawssecurities legislation. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to securities legislation of the public by such Securities Regulators in accordance with securities legislationapplicable province. Each Subscriber (and for certainty, including each Disclosed Principal) hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is madeauthority. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulatorsecurities regulatory authorities, the Subscriber should contact the appropriate Securities Regulator applicable securities regulatory authority at the addresses set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authoritiesat Schedule "C" hereto. The Subscriber’s (and if applicable, each Disclosed Principal’s) personal information may be disclosed by the Corporation to: (a) regulatory authorities (including stock exchanges, if applicable); (b) the Corporation’s registrar and transfer agent; (c) taxation authorities; and (d) any of the other parties involved in the Offering, including legal counsel. By executing this Agreement, the Subscriber acknowledges (and consents if applicable, any other Disclosed Principal) is deemed to be consenting to the fact that foregoing collection (including the Fund and/or the Manager is collecting indirect collection of personal information), use and disclosure of the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreementinformation. The Subscriber acknowledges (and if applicable, the Disclosed Principal) also consents to the Manager and/or filing of copies or originals of any of the Fund retaining such personal information for Subscriber’s documents described in this Subscription Agreement as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of to be filed with any stock exchange to provide or securities regulatory authorities authority in connection with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:transactions contemplated hereby.

Appears in 2 contracts

Samples: Subscription Agreement (Edesa Biotech, Inc.), Subscription Agreement (Edesa Biotech, Inc.)

Collection of Personal Information. The Subscriber hereby acknowledges and understands that: The information provided by the Subscriber (on the Face Page identifying the nameits own behalf and, address and telephone number if applicable, on behalf of the Subscriber, whether the any person for whose benefit Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber subscribing) acknowledges and consents to the fact that the Fund and/or the Manager Company is collecting the Subscriber’s (and any beneficial purchaser’s) personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time pursuant to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber (on its own behalf and, if applicable, on behalf of any person for whose benefit Subscriber is subscribing) acknowledges and consents to the Manager and/or Company retaining the Fund retaining such personal information for as long as permitted or required by applicable law or business practices. The Subscriber (on its own behalf and, if applicable, on behalf of any person for whose benefit Subscriber is subscribing) further acknowledges and consents to the fact that the Manager and/or the Fund Company may be required by the Securities Laws applicable securities laws and the rules and policies of any stock exchange rules to provide regulatory authorities with any personal information provided by Subscriber respecting itself (and any beneficial purchaser). By executing this Agreement, Subscriber is deemed to be consenting to the foregoing collection, use and disclosure of Subscriber’s (and any beneficial purchaser’s) personal information. Subscriber also consents to the filing of copies or originals of any of Subscriber’s documents described herein as may be required to be filed with any stock exchange or securities regulatory authority in connection with the transactions contemplated hereby. Subscriber represents and warrants that it has the authority to provide the consents and acknowledgments set out in this paragraph on behalf of all beneficial purchasers. “SUBSCRIBER” Tensile Capital Partners Master Fund LP By: Tensile Capital GP LLC Its: General Partner By: /s/ Dxxxxxx X. Xxxxxx Name: Dxxxxxx X. Xxxxxx Its: Manager Date: Subscription Agreement. In addition to the foregoingAgreement Vertex Energy, Inc. Accepted by: “COMPANY” Vertex Energy, Inc. By: /s/ Bxxxxxxx X. Xxxxxx Name: Bxxxxxxx X. Xxxxxx Its: CEO Date: ______ By: Name: Its: Date: Subscription Agreement Vertex Energy, Inc. Exhibit A CERTIFICATE OF ACCREDITED INVESTOR STATUS AND INVESTOR INFORMATION As indicated below, the Subscriber agrees undersigned is an “accredited investor,” as that term is defined in Regulation D of the Securities Act of 1933, as amended (the “Securities Act”). The undersigned has initialed the line below indicating the basis on which he, she or it is representing his, her or its status as an “accredited investor”, at the request of Vertex Energy, Inc., a Nevada corporation (the “Company”). The representation and acknowledges confirmation below as part of this Certification of Accredited Investor Status And Investor Information shall be effective for all purposes and shall be able to be relied upon by the Company, its legal counsel and assigns for any and all purposes, until such time, if ever, as the undersigned has advised the Company that the Manager and/or representations below are no longer accurate or correct. By initializing below the Fund may use undersigned confirms, acknowledges and disclose represents that he, she or it, is an “accredited investor” because he, she or it is: ______ a bank as defined in Section 3(a)(2) of the Securities Act, or any savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Securities Act whether acting in its personal information individual or fiduciary capacity; a broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934, as follows:amended (the “Securities Exchange Act”); an insurance company as defined in Section 2(13) of the Securities Act; an investment company registered under the Investment Company Act of 1940 or a business development company as defined in Section 2(a)(48) of that Act; a small business investment company licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958; a plan established and maintained by a state, its political subdivisions, or any agency or instrumentality of a state or its political subdivisions, for the benefit of its employees, and such plan has total assets in excess of $5,000,000; an employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974, if the investment decision is made by a plan fiduciary, as defined in Section 3(21) of such Act, which is either a bank, savings and loan association, insurance company, or registered investment adviser, or if the employee benefit plan has total assets in excess of $5,000,000 or, if a self-directed plan, with investment decisions made solely by persons that are “accredited investors”; ____ a private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940; ____ an organization described in Section 501(c)(3) of the Internal Revenue Code, corporation, Massachusetts or similar business trust, or partnership, not formed for the specific purpose of acquiring the securities offered, with total assets in excess of $5,000,000;

Appears in 1 contract

Samples: Subscription Agreement (Vertex Energy Inc.)

Collection of Personal Information. The Subscriber hereby acknowledges This Subscription Agreement and understands that: The information provided by the schedules hereto require the Subscriber on to provide certain personal information (respecting the Face Page identifying Subscriber and, if applicable, the name, address and telephone number of the Subscriber, whether Disclosed Principal for whom the Subscriber is an “insider” of contracting) to the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder Corporation and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such Underwriters. (Personal information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s includes “personal information (information” as that term is defined under applicable privacy legislation, including, including without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, similar replacement or supplemental provincial or federal legislation or laws and the policies of the Stock Exchange in effect from time to time). Such information is being collected for the purposes of completing the Offering, or that which includes determining the eligibility of each the Subscriber or, if applicable, the beneficial purchaser for whom it the Subscriber is contracting, to purchase the Subscription Receipts under Securities Laws, preparing and registering certificates representing the Subscription Receipts to be issued hereunder and completing filings required under Securities Laws or by any stock exchange, the Investment Industry Regulatory Organization of Canada and/or securities regulatory authorities. Such personal information may be used by the Corporation to communicate with the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting hereunder(such as by providing annual or quarterly reports), to prepare tax filings and forms or to comply with its obligations under taxation, securities and other laws (such as maintaining a list of holders of securities). In connection with the foregoing, the personal information of the Subscriber or, if applicable, the beneficial purchaser for whom the purpose Subscriber is contracting, may be disclosed by the Corporation or the Underwriters to: (i) any stock exchanges, securities regulatory authorities or as required by law; (ii) the Corporation's registrar and transfer agent (if applicable) or the subscription receipt agent under the Subscription Receipt Agreement; and (iii) legal counsel of completing the Underwriters or legal counsel to or the auditors of the Corporation, and may be included in record books prepared in respect of the Offering. By executing this Subscription Agreement, the Subscriber (on its own behalf and, if applicable, on behalf of any Disclosed Principal) hereby consents to the limited collection, use and disclosure of such personal information. The Subscriber (on its own behalf and, if applicable, on behalf of the beneficial purchaser for whom the Subscriber is contracting) also consents to the filing of copies or originals of any of the documents provided to the Corporation or the Underwriters by or on behalf of the Subscriber with any securities regulatory authority in relation to the transactions contemplated by this Subscription Agreement. The Subscriber acknowledges that the Subscriber's personal information and consents the personal information of any Disclosed Principal may be delivered to the Manager and/or securities commissions in the Fund retaining provinces and territories of Canada and is thereby being collected indirectly by such securities commissions under the authority granted to each of them in securities legislation for the purposes of administration and enforcement of the securities legislation of such province or territory and authorizes such indirect collection. The public official who can answer questions about such securities regulatory authorities’ indirect collection of personal information for as long as permitted is listed below: Alberta Securities Commission Xxxxx 000, 000 – 0xx Xxxxxx XX Xxxxxxx, Xxxxxxx X0X 0X0 Telephone: 000-000-0000 Toll free in Canada: 0-000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: FOIP Coordinator The Manitoba Securities Commission 500 – 000 Xx. Xxxx Xxxxxx Winnipeg, Manitoba R3C 4K5 Telephone: 000-000-0000 Toll free in Manitoba 0-000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Director British Columbia Securities Commission X.X. Xxx 00000, Xxxxxxx Xxxxxx 000 Xxxx Xxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx X0X 0X0 Inquiries: 000-000-0000 Toll free in Canada: 0-000-000-0000 Facsimile: 000-000-0000 Email: XXX-xxxxxxx@xxxx.xx.xx Public official contact regarding indirect collection of information: FOI Inquiries Autorité des marchés financiers 000, Xxxxxx Xxxxxxxx, 00x étage C.P. 000, Xxxx xx xx Xxxxxx Xxxxxxxx, Xxxxxx X0X 0X0 Telephone: 000-000-0000 or required by law or business practices. The Subscriber further acknowledges 0-000-000-0000 Facsimile: 000-000-0000 (For filing purposes only) Facsimile: 000-000-0000 (For privacy requests only) Email: xxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxx.xx.xx Public official contact regarding indirect collection of information: Secrétaire générale Ontario Securities Commission 00 Xxxxx Xxxxxx Xxxx, 00xx Xxxxx Xxxxxxx, Xxxxxxx X0X 0X0 Telephone: 416-593- 8314 Toll free in Canada: 0-000-000-0000 Facsimile: 000-000-0000 Email: xxxxxxxxxxxxxxxxxxx@xxx.xxx.xx.xx Nova Scotia Securities Commission Xxxxx 000, 0000 Xxxx Xxxxxx Xxxx Tower X.X. Xxx 000 Xxxxxxx, Xxxx Xxxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of Public official contact regarding indirect collection of information: Inquiries Officer information: Executive Director Xxxxxx Xxxxxx Island Securities Office 00 Xxxxxxxx Xxxxxx, 4th Floor Xxxx Building P.O. Box 2000 Charlottetown, Xxxxxx Xxxxxx Island CIA 7N8 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Government of the Northwest Territories, Office of the Superintendent of Securities X.X. Xxx 0000 Xxxxxxxxxxx, Xxxxxxxxx Xxxxxxxxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Government of Nunavut Department of Justice Legal Registries Division, P.O. Box 1000, Station 000, 0xx Xxxxx, Xxxxx Xxxxxxxx Xxxxxxx, Xxxxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Financial and consents to Consumer Services Commission (New Brunswick) 00 Xxxxxxxxx Xxxxxx, Xxxxx 000 Xxxxx Xxxx, New Brunswick E2L 2J2 Telephone: 000-000-0000 Toll free in Canada: 0-000-000-0000 Facsimile: (000) 000-0000 Email: xxxx@xxxx.xx Public official contact regarding indirect collection of information: Chief Executive Officer and Privacy Officer Government of Newfoundland and Labrador Financial Services Regulation Division X.X. Xxx 0000 Xxxxxxxxxxxxx Xxxxxxxx 0xx Xxxxx, Xxxx Xxxxx Xxxxxx Xxxxxx Drive St. John’s, Newfoundland and Labrador A1B 4J6 Attention: Director of Securities Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Financial and Consumer Affairs Authority of Saskatchewan Suite 000-0000 Xxxxxxxxxxxx Xxxxx Xxxxxx, Xxxxxxxxxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Director Government of Yukon Department of Community Services, Office of the fact that the Manager and/or the Fund may be required by the Superintendent of Securities Laws 000 Xxxxx Xxxxxx Xxxxxxxxxx, Xxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities SCHEDULE A RISK FACTORS AND OTHER DISCLOSURE Capitalized terms used and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber not defined in this Subscription Agreement. In addition Schedule A shall have the meaning attributed to such terms in the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:term sheet attached hereto at Schedule B.

Appears in 1 contract

Samples: Underwriting Agreement

Collection of Personal Information. The By executing this Subscription Agreement, the Subscriber hereby acknowledges consents to the collection, use and understands that: The disclosure of the personal information provided herein and other personal information provided by the Subscriber or collected by the Corporation or its agents as reasonably necessary in connection with the Subscriber’s subscription for the Subscribed Shares (collectively, “personal information”) as follows: (a) the Corporation may use personal information and disclose personal information to intermediaries such as the Corporation’s legal counsel and withholding and/or transfer agents for the purposes of determining the Subscriber’s eligibility to invest in the Subscribed Shares and for managing and administering the Subscriber’s investment in the Subscribed Shares; (b) if the Subscriber purchased securities through a registered dealer, the Corporation may disclose and collect such personal information relating to the Subscriber’s holding of the Subscribed Shares to and from the dealer; (c) the Corporation and its agents may use the Subscriber’s social insurance number for income reporting purposes in accordance with applicable law; (d) the Corporation, its agents and advisors, may each collect, use and disclose personal information for the purposes of meeting legal, regulatory, self-regulatory, security and audit requirements (including any applicable tax, securities, money laundering or anti-terrorism legislation, rules or regulations) and as otherwise permitted or required by law, which disclosures may include disclosures to tax, securities or other regulatory or self-regulatory authorities in Canada and/or in foreign jurisdictions, if applicable, in connection with the regulatory oversight mandate of such authorities; (e) the Corporation and its agents and advisors may use personal information and disclose personal information to parties connected with the proposed or actual transfer, sale, assignment, merger or amalgamation of the Corporation or its business or assets or similar transactions, for the purpose of permitting such parties to evaluate and/or proceed with and complete such transaction. Purchasers, assignees and successors of the Corporation or its business or assets may collect, use and disclose personal information as described in this Subscription Agreement. The Subscriber acknowledges that the Corporation’s agents or intermediaries may be located outside of Canada, and personal information may be transferred and/or processed outside of Canada for the purposes described above, and that measures the Issuer may use to protect personal information while handled by agents, intermediaries or other third parties on its behalf, and personal information otherwise disclosed or transferred outside of Canada for the Face Page identifying purposes described above, are subject to legal requirements in foreign countries applicable to Issuer or such third parties, for example lawful requirements to disclose personal information to government authorities in those countries. If the Subscriber is resident in, or otherwise subject to the applicable securities legislation of Ontario, the Subscriber acknowledges (i) the delivery to the Ontario Securities Commission of the Subscriber’s full name, residential address and telephone number, the number and type of securities purchased by the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawstotal purchase price, the number of Units being purchased hereunder exemption relied on, and the Subscription Amount as well as the Closing Date and the exemption date of distribution, (ii) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being collected indirectly collected by such the Ontario Securities Regulators Commission under the authority granted under Securities Laws. This to it in securities legislation, (iii) that such information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario, and may be disclosed (iv) that the Administrative Assistant to the public by Director of Corporate Finance at the Ontario Securities Commission, Sxxxx 0000, Xxx 00, 20 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, telephone (000) 000-0000, can be contacted to answer questions about the Ontario Securities Commission’s indirect collection of such Securities Regulators in accordance with securities legislationinformation. Each The Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Ontario Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:Commission.

Appears in 1 contract

Samples: Subscription Agreement (Apollo Gold Corp)

Collection of Personal Information. The Subscriber Investor hereby acknowledges consents to the collection, use and understands that: The information provided disclosure by the Subscriber on the Face Page identifying the name, address Company and telephone number any other of its authorized representatives of the Subscriber, whether the Subscriber is an “insider” Personal Information of the Fund and/or a “registrant” as each term is defined under Investor and recognizes that this disclosure may result in the Securities Lawsdisclosure of some or all of the Personal Information becoming public information and, without limiting the number of Units being purchased hereunder and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed foregoing, consents to the Securities Regulators, disclosure of such Personal Information to the Company and such information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes any of its other authorized representatives or to any Governmental Authority; provided that no Personal Information of the administration Investor shall be provided to the Company, any of its Subsidiaries or any of its other authorized representatives and enforcement none of the Securities Laws and may be disclosed Company nor any of its Subsidiaries or any other of its authorized representatives shall disclose to the public or any Governmental Authority any Personal Information about the Investor or the Offering, in each case other than as required by such Securities Regulators applicable law or any Governmental Authority; provided further that the Company shall notify the Investor in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and writing prior to disclosure of such any Personal Information (other than information contained in the 72-503F Report of Trade) and, if requested by the Investor and permitted by applicable securities regulatory authorities laws, use commercially reasonable efforts to seek confidential treatment of such Personal Information at the Company’s cost and expense (the disclosure conditions set forth in each of this paragraph, the jurisdictions in which the offering of Units is made“Disclosure Conditions”). In the event the Subscriber has any questions with respect Subject to the indirect collection Disclosure Conditions, in order to permit the Company to comply with the requirements of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and Investor expressly consents to the Manager and/or disclosure by the Fund retaining such personal information for as long as permitted Company in any submission or required by law or business practices. The Subscriber further acknowledges and consents to the fact filing that the Manager and/or the Fund Company may be required to make with any Governmental Authority of any Personal Information. The Investor hereby acknowledges and agrees that it (i) will be notified by the Company in writing prior to the delivery of the Personal Information to applicable Governmental Authorities, that the Personal Information will be collected by the applicable Governmental Authority under the authority granted pursuant to Canadian Securities Laws Laws, and that the rules Personal Information will be collected by the applicable Governmental Authority for the purposes of the administration and policies enforcement of applicable Canadian Securities Laws, and (ii) has authorized the indirect collection of the Personal Information by the applicable Governmental Authority, subject to the Disclosure Conditions. The Personal Information will not be placed on the public file of any stock exchange Governmental Authority. However, freedom of information legislation may require the Governmental Authority to provide regulatory authorities with make this information available if requested. If the Investor has any personal information provided by questions about the Subscriber in this Subscription Agreement. In addition to collection and use of the foregoingPersonal Information and/or the Governmental Authority’s indirect collection of the Personal Information, the Subscriber Investor hereby acknowledges and agrees and acknowledges that it has been notified to contact the Manager and/or the Fund may use and disclose its personal information as follows:Inquiries Officer, Ontario Securities Commission, 00 Xxxxx Xxxxxx Xxxx, 00xx Xxxxx, Xxxxxxx, Xxxxxxx X0X 0X0, Telephone: (000) 000-0000, Toll free in Canada: 0-000-000-0000, Facsimile: (000) 000-0000, Email: xxxxxxxxxxxxxxxxxxx@xxx.xxx.xx.xx.

Appears in 1 contract

Samples: Subscription Agreement (Charlotte's Web Holdings, Inc.)

Collection of Personal Information. This Subscription Agreement requires the Subscriber to provide certain personal information to the Corporation. Such information is being collected by the Corporation for the purposes of completing the Offering, which includes, without limitation, determining the Subscriber’s eligibility to purchase the Securities under applicable securities legislation, preparing and registering certificates (or other evidence of subscription) representing the Common Shares and Warrants to be issued to the Subscriber and completing filings required by taxation authorities and any stock exchange or securities regulatory authority. Securities regulatory authorities in each of the provinces of Canada have been granted the authority to indirectly collect this personal information pursuant to securities legislation and this personal information is also being collected for the purpose of administration and enforcement of securities legislation. The Subscriber hereby acknowledges and understands that: The consents to the collection, use, and disclosure of certain personal information by securities regulatory authorities in Canada. If the Subscriber is resident in or otherwise subject to the securities laws applicable in another province of Canada, the information provided by the Subscriber on the Face Page first page of this Subscription Agreement identifying the name, address and telephone number of the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder and the Subscription Amount subscription price, as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units Securities will be disclosed to the Securities Regulatorsapplicable securities regulatory authority, and such information is being indirectly collected by such Securities Regulators securities regulatory authority under the authority granted to it under Securities Lawssecurities legislation. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to securities legislation of the public by such Securities Regulators in accordance with securities legislationapplicable province. Each Subscriber (and for certainty, including each Disclosed Principal) hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is madeauthority. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulatorsecurities regulatory authorities, the Subscriber should contact the appropriate Securities Regulator applicable securities regulatory authority at the addresses set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authoritiesat Schedule B hereto. The Subscriber’s (and if applicable, each Disclosed Principal’s) personal information may be disclosed by the Corporation to: (a) regulatory authorities (including stock exchanges, if applicable); (b) the Corporation’s registrar and transfer agent; (c) taxation authorities; and (d) any of the other parties involved in the Offering, including legal counsel. By executing this Agreement, the Subscriber acknowledges (and consents if applicable, any other Disclosed Principal) is deemed to be consenting to the fact that foregoing collection (including the Fund and/or the Manager is collecting indirect collection of personal information), use and disclosure of the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreementinformation. The Subscriber acknowledges (and if applicable, the Disclosed Principal) also consents to the Manager and/or filing of copies or originals of any of the Fund retaining such personal information for Subscriber’s documents described in this Subscription Agreement as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of to be filed with any stock exchange to provide or securities regulatory authorities authority in connection with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:transactions contemplated hereby.

Appears in 1 contract

Samples: Subscription Agreement (Edesa Biotech, Inc.)

Collection of Personal Information. The By executing this Subscription Agreement, the Subscriber hereby acknowledges consents to the collection, use and understands that: The disclosure of the personal information provided herein and other personal information provided by the Subscriber or collected by the Corporation or its agents as reasonably necessary in connection with the Subscriber's subscription for the Subscribed Shares (collectively, "personal information") as follows: (a) the Corporation may use personal information and disclose personal information to intermediaries such as the Corporation's legal counsel and withholding and/or transfer agents for the purposes of determining the Subscriber's eligibility to invest in the Subscribed Shares and for managing and administering the Subscriber's investment in the Subscribed Shares; (b) if the Subscriber purchased securities through a registered dealer, the Corporation may disclose and collect such personal information relating to the Subscriber's holding of the Subscribed Shares to and from the dealer; (c) the Corporation and its agents may use the Subscriber's social insurance number for income reporting purposes in accordance with applicable law; (d) the Corporation, its agents and advisors, may each collect, use and disclose personal information for the purposes of meeting legal, regulatory, self-regulatory, security and audit requirements (including any applicable tax, securities, money laundering or anti-terrorism legislation, rules or regulations) and as otherwise permitted or required by law, which disclosures may include disclosures to tax, securities or other regulatory or self-regulatory authorities in Canada and/or in foreign jurisdictions, if applicable, in connection with the regulatory oversight mandate of such authorities; (e) the Corporation and its agents and advisors may use personal information and disclose personal information to parties connected with the proposed or actual transfer, sale, assignment, merger or amalgamation of the Corporation or its business or assets or similar transactions, for the purpose of permitting such parties to evaluate and/or proceed with and complete such transaction. Purchasers, assignees and successors of the Corporation or its business or assets may collect, use and disclose personal information as described in this Subscription Agreement. The Subscriber acknowledges that the Corporation's agents or intermediaries may be located outside of Canada, and personal information may be transferred and/or processed outside of Canada for the purposes described above, and that measures the Issuer may use to protect personal information while handled by agents, intermediaries or other third parties on its behalf, and personal information otherwise disclosed or transferred outside of Canada for the Face Page identifying purposes described above, are subject to legal requirements in foreign countries applicable to Issuer or such third parties, for example lawful requirements to disclose personal information to government authorities in those countries. If the Subscriber is resident in, or otherwise subject to the applicable securities legislation of Ontario, the Subscriber acknowledges (i) the delivery to the Ontario Securities Commission of the Subscriber's full name, residential address and telephone number, the number and type of securities purchased by the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawstotal purchase price, the number of Units being purchased hereunder exemption relied on, and the Subscription Amount as well as the Closing Date and the exemption date of distribution, (ii) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being collected indirectly collected by such the Ontario Securities Regulators Commission under the authority granted under Securities Laws. This to it in securities legislation, (iii) that such information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario, and may be disclosed (iv) that the Administrative Assistant to the public by Director of Corporate Finance at the Ontario Securities Commission, Xxxxx 0000, Xxx 00, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, telephone (000) 000-0000, can be contacted to answer questions about the Ontario Securities Commission's indirect collection of such Securities Regulators in accordance with securities legislationinformation. Each The Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Ontario Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:Commission.

Appears in 1 contract

Samples: Subscription Agreement (Brigus Gold Corp.)

Collection of Personal Information. The Subscriber hereby acknowledges that this Subscription Agreement and understands that: The Schedule “A” hereto require the Subscriber to provide certain personal information provided to the Corporation. Such information is being collected by the Corporation for the purposes of completing the Offering, which includes, without limitation, determining the Subscriber’s eligibility (or, if applicable, the eligibility of the disclosed Beneficial Purchaser) to purchase the Warrants under applicable securities legislation, preparing and registering certificates representing the Securities to be issued hereunder and completing filings required by any stock exchange or securities regulatory authority. The Subscriber’s personal information (and, if applicable, the disclosed Beneficial Purchaser’s personal information) may be disclosed by the Corporation to: (a) stock exchanges or securities regulatory authorities, (b) the Corporation’s registrar and transfer agent, (c) any government agency, board or other entity; and (d) any of the other parties involved in the Offering, including the Corporation, the Agent and their respective legal counsel, and may be included in record books in connection with the Offering. By executing this Subscription Agreement, the Subscriber on (and, if applicable, the Face Page identifying disclosed Beneficial Purchaser) is deemed to be consenting to the foregoing collection, use and disclosure of the Subscriber’s personal information (and, if applicable, the disclosed Beneficial Purchaser’s personal information). The Subscriber (and, if applicable, the disclosed Beneficial Purchaser) also consents to the filing of copies or originals of any of the documents described in Section 4.2 of this Subscription Agreement as may be required to be filed with any stock exchange or securities regulatory authority in connection with the transactions contemplated hereby and consents to the disclosure of such information to the public through the filing of a report of trade with applicable Securities Regulators. The Subscriber (and, if applicable, the disclosed Beneficial Purchaser) further acknowledges that it has been notified by the Corporation of and authorizes (a) the delivery to the Ontario Securities Commission (the “OSC”) of the full name, residential address and telephone number of the SubscriberSubscriber (and, whether if applicable, the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawsdisclosed Beneficial Purchaser), the number and type of Units being purchased hereunder securities purchased, the total purchase price, the exemption relied upon and the Subscription Amount as well as the Closing Date and the exemption date of distribution; (b) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such this information is being collected indirectly collected by such Securities Regulators the OSC under the authority granted under Securities Laws. This to it in securities legislation; (c) that this information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario; and may be disclosed (d) that the Administrative Assistant to the public by such Director of Corporate Finance can be contacted at Ontario Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has Commission, Xxxxx 0000, Xxx 00, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, or at (000) 000-0000, regarding any questions with respect to about the OSC’s indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:information.

Appears in 1 contract

Samples: Subscription Agreement for Special (Yukon Gold Corp Inc)

Collection of Personal Information. The Subscriber hereby acknowledges and understands consents to the fact that the Issuer is collecting the Subscriber’s personal information for the purpose of fulfilling this Agreement and completing the Offering. The Subscriber acknowledges that the Subscriber’s personal information (and, if applicable, the personal information of those on whose behalf the Subscriber is contracting hereunder) may be included in record books in connection with the Offering and may be disclosed by the Issuer to: (a) securities regulatory authorities, (b) the Issuer’s registrar and transfer agent, (c) Canadian tax authorities, (d) authorities pursuant to the Proceeds of Crime (Money Laundering) and Terrorist Financing Act (Canada) and (e) any of the other parties involved in the Offering, including the Issuer’s Counsel. By executing this Agreement, the Subscriber is deemed to be consenting to the foregoing collection, use and disclosure of the Subscriber's personal information (and, if applicable, the personal information of those on whose behalf the Subscriber is contracting hereunder) for the foregoing purposes and to the retention of such personal information for as long as permitted or required by applicable laws. Notwithstanding that the Subscriber may be purchasing the Units as agent on behalf of an undisclosed principal, the Subscriber agrees to provide, on request, particulars as to the nature and identity of such undisclosed principal, and any interest that such undisclosed principal has in the Issuer, all as may be required by the Issuer in order to comply with the foregoing. Furthermore, the Subscriber is hereby notified that: The information provided by the Issuer may deliver to any securities commission having jurisdiction over the Issuer, the Subscriber on or this Subscription, including any Canadian provincial securities commissions, the Face Page identifying United States Securities and Exchange Commission and/or any state securities commissions (collectively, the “Commissions”), certain personal information pertaining to the Subscriber, including the Subscriber’s full name, residential address and telephone number of the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawsnumber, the number of Units being or other securities of the Issuer owned by the Subscriber, the number of Units purchased hereunder by the Subscriber, the total Subscription Amount paid for the Units, the prospectus exemption relied on by the Issuer and the Subscription Amount as well as date of distribution of the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and Securities; such information is being collected indirectly collected by such Securities Regulators the Commissions under the authority granted under Securities Laws. This to them in applicable securities laws; such information is being collected for the purposes of the administration and enforcement of applicable securities laws; and the Securities Laws and Subscriber may be disclosed to contact the public by such Securities Regulators official in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions province with respect to questions about the commission’s indirect collection of such information by at the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out address and telephone number found in Appendix VII “B” Contact Indirect Collection of Personal Information for attached to the Canadian Securities Regulatory AuthoritiesOffering Document. Costs The Subscriber acknowledges and consents to the fact agrees that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection all costs and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided expenses incurred by the Subscriber in this Subscription Agreement. In addition (including any fees and disbursements of any special counsel retained by the Subscriber) relating to the foregoing, purchase of the Subscriber agrees and acknowledges that Units will be borne by the Manager and/or the Fund may use and disclose its personal information as follows:Subscriber.

Appears in 1 contract

Samples: reynasilver.com

Collection of Personal Information. The Subscriber hereby acknowledges This Subscription Agreement and understands that: The information provided by the schedules hereto require the Subscriber on to provide certain personal information (respecting the Face Page identifying Subscriber and, if applicable, the name, address and telephone number of the Subscriber, whether Disclosed Principal for whom the Subscriber is an “insider” of contracting) to the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder Corporation and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such Underwriters. (Personal information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s includes “personal information (information” as that term is defined under applicable privacy legislation, including, including without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, similar replacement or supplemental provincial or federal legislation or laws and the policies of the Stock Exchange in effect from time to time). Such information is being collected for the purposes of completing the Offering, or that which includes determining the eligibility of each the Subscriber or, if applicable, the beneficial purchaser for whom it the Subscriber is contracting, to purchase the Subscription Receipts under Securities Laws, preparing and registering certificates representing the Subscription Receipts to be issued hereunder and completing filings required under Securities Laws or by any stock exchange, the Investment Industry Regulatory Organization of Canada and/or securities regulatory authorities. Such personal information may be used by the Corporation to communicate with the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting hereunder(such as by providing annual or quarterly reports), to prepare tax filings and forms or to comply with its obligations under taxation, securities and other laws (such as maintaining a list of holders of securities). In connection with the foregoing, the personal information of the Subscriber or, if applicable, the beneficial purchaser for whom the purpose Subscriber is contracting, may be disclosed by the Corporation or the Underwriters to: (i) any stock exchanges, securities regulatory authorities or as required by law; (ii) the Corporation's registrar and transfer agent (if applicable) or the subscription receipt agent under the Subscription Receipt Agreement; and (iii) legal counsel of completing the Underwriters or legal counsel to or the auditors of the Corporation, and may be included in record books prepared in respect of the Offering. By executing this Subscription Agreement, the Subscriber (on its own behalf and, if applicable, on behalf of any Disclosed Principal) hereby consents to the limited collection, use and disclosure of such personal information. The Subscriber (on its own behalf and, if applicable, on behalf of the beneficial purchaser for whom the Subscriber is contracting) also consents to the filing of copies or originals of any of the documents provided to the Corporation or the Underwriters by or on behalf of the Subscriber with any securities regulatory authority in relation to the transactions contemplated by this Subscription Agreement. The Subscriber acknowledges that the Subscriber's personal information and consents the personal information of any Disclosed Principal may be delivered to the Manager and/or securities commissions in the Fund retaining provinces and territories of Canada and is thereby being collected indirectly by such securities commissions under the authority granted to each of them in securities legislation for the purposes of administration and enforcement of the securities legislation of such province or territory and authorizes such indirect collection. The public official who can answer questions about such securities regulatory authorities’ indirect collection of personal information for as long as permitted is listed below: Alberta Securities Commission Xxxxx 000, 000 – 0xx Xxxxxx XX Xxxxxxx, Xxxxxxx X0X 0X0 Telephone: 000-000-0000 Toll free in Canada: 0-000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: FOIP Coordinator The Manitoba Securities Commission 500 – 000 Xx. Xxxx Xxxxxx Winnipeg, Manitoba R3C 4K5 Telephone: 000-000-0000 Toll free in Manitoba 0-000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Director British Columbia Securities Commission X.X. Xxx 00000, Xxxxxxx Xxxxxx 000 Xxxx Xxxxxxx Xxxxxx Xxxxxxxxx, Xxxxxxx Xxxxxxxx X0X 0X0 Inquiries: 000-000-0000 Toll free in Canada: 1-800-373-6393 Facsimile: 000-000-0000 Email: XXX-xxxxxxx@xxxx.xx.xx Public official contact regarding indirect collection of information: FOI Inquiries Autorité des marchés financiers 000, Xxxxxx Xxxxxxxx, 00x étage C.P. 000, Xxxx xx xx Xxxxxx Xxxxxxxx, Xxxxxx X0X 0X0 Telephone: 000-000-0000 or required by law or business practices. The Subscriber further acknowledges 1-877-525-0337 Facsimile: 000-000-0000 (For filing purposes only) Facsimile: 000-000-0000 (For privacy requests only) Email: xxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxx.xx.xx Public official contact regarding indirect collection of information: Secrétaire générale Ontario Securities Commission 00 Xxxxx Xxxxxx Xxxx, 00xx Xxxxx Xxxxxxx, Xxxxxxx X0X 0X0 Telephone: 416-593- 8314 Toll free in Canada: 1-877-785-1555 Facsimile: 000-000-0000 Email: xxxxxxxxxxxxxxxxxxx@xxx.xxx.xx.xx Nova Scotia Securities Commission Xxxxx 000, 0000 Xxxx Xxxxxx Xxxx Tower X.X. Xxx 000 Xxxxxxx, Xxxx Xxxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of Public official contact regarding indirect collection of information: Inquiries Officer information: Executive Director Xxxxxx Xxxxxx Island Securities Office 00 Xxxxxxxx Xxxxxx, 4th Floor Xxxx Building P.O. Box 2000 Charlottetown, Xxxxxx Xxxxxx Island CIA 7N8 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Government of the Northwest Territories, Office of the Superintendent of Securities X.X. Xxx 0000 Xxxxxxxxxxx, Xxxxxxxxx Xxxxxxxxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Government of Nunavut Department of Justice Legal Registries Division, P.O. Box 1000, Station 000, 0xx Xxxxx, Xxxxx Xxxxxxxx Iqaluit, Nunavut X0A 0H0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Financial and consents to Consumer Services Commission (New Brunswick) 00 Xxxxxxxxx Xxxxxx, Xxxxx 000 Xxxxx Xxxx, New Brunswick E2L 2J2 Telephone: 000-000-0000 Toll free in Canada: 1-866-933-2222 Facsimile: (000) 000-0000 Email: xxxx@xxxx.xx Public official contact regarding indirect collection of information: Chief Executive Officer and Privacy Officer Government of Newfoundland and Labrador Financial Services Regulation Division X.X. Xxx 0000 Xxxxxxxxxxxxx Xxxxxxxx 0xx Xxxxx, Xxxx Xxxxx Xxxxxx Xxxxxx Drive St. John’s, Newfoundland and Labrador A1B 4J6 Attention: Director of Securities Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities Financial and Consumer Affairs Authority of Saskatchewan Suite 000-0000 Xxxxxxxxxxxx Xxxxx Xxxxxx, Saskatchewan S4P 4H2 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Director Government of Yukon Department of Community Services, Office of the fact that the Manager and/or the Fund may be required by the Superintendent of Securities Laws 000 Xxxxx Xxxxxx Xxxxxxxxxx, Xxxxx X0X 0X0 Telephone: 000-000-0000 Facsimile: 000-000-0000 Public official contact regarding indirect collection of information: Superintendent of Securities SCHEDULE A RISK FACTORS AND OTHER DISCLOSURE Capitalized terms used and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber not defined in this Subscription Agreement. In addition Schedule A shall have the meaning attributed to such terms in the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:term sheet attached hereto at Schedule B.

Appears in 1 contract

Samples: Underwriting Agreement

Collection of Personal Information. The Subscriber hereby acknowledges and understands that: The information provided by the Subscriber on the Face Page identifying the name, address and telephone number of the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder This Agreement and the Subscription Amount as well as schedules hereto require the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed Lender to the Securities Regulators, and such information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s provide certain personal information (respecting the Lender) to the Corporation. (Personal information includes "personal information" as that term is defined under applicable privacy legislation, including, including without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, similar replacement or supplemental provincial or federal legislation or laws and the policies of the NASDAQ in effect from time to time). Such information is being collected for the purposes of completing the conversion of the Debt into Payment Shares, which includes, without limitation, determining the eligibility of the Lender to acquire the Payment Shares under applicable securities laws, preparing and registering certificates representing the Payment Shares to be issued hereunder and completing filings required under applicable Securities Laws or that by any stock exchange, the Investment Industry Regulatory Organization of each beneficial purchaser for whom it is contracting hereunderCanada and/or securities regulatory authorities. In addition, such personal information may be used or disclosed by the Corporation for the purpose of completing this Subscription Agreementadministering the Corporation’s relationship with the Lender. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining For example, such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required used by the Securities Laws Corporation to communicate with the Lender (such as by providing annual or quarterly reports), to prepare tax filings and the rules forms or to comply with its obligations under taxation, securities and policies other laws (such as maintaining a list of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreementholders of shares). In addition to connection with the foregoing, the Subscriber agrees personal information of the Lender may be disclosed by the Corporation to: (i) any stock exchanges or securities regulatory or taxation authorities; (ii) the Corporation’s registrar and transfer agent (if applicable); and (iii) any of the other parties involved in the conversion of the Debt into Payment Shares, including legal counsel, and may be included in record books prepared in respect of the transaction. By executing this Agreement, the Lender hereby consents to the collection, use and disclosure of such personal information. The Lender also consents to the filing of copies or originals of any of the documents provided to the Corporation by or on behalf of the Lender with any securities regulatory authority in relation to the transactions contemplated by this Agreement. The Lender acknowledges that the Manager and/or the Fund may use and disclose its Lender’s personal information as follows:may be delivered to the Ontario Securities Commission and is thereby being collected indirectly by the Ontario Securities Commission under the authority granted to it in securities legislation for the purposes of administration and enforcement of the securities legislation of Ontario. The public official in Ontario who can answer questions about the Ontario Securities Commission’s indirect collection of personal information is: Administrative Support Clerk to the Director of Corporate Finance, Xxxxx 0000, Xxx 0000, Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx, X0X 0X0, Telephone (000) 000 0000. [Remainder of this page intentionally left blank.]

Appears in 1 contract

Samples: Conversion of Debt Agreement (Sphere 3D Corp)

Collection of Personal Information. The Subscriber hereby acknowledges that this Subscription Agreement and understands that: The Schedule “A” hereto require the Subscriber to provide certain personal information provided to the Corporation. Such information is being collected by the Corporation for the purposes of completing the Offering, which includes, without limitation, determining the Subscriber’s eligibility (or, if applicable, the eligibility of the Disclosed Principal) to purchase the Units under applicable securities legislation, preparing and registering certificates representing the Units to be issued hereunder and completing filings required by any stock exchange or securities regulatory authority. The Subscriber’s personal information (and, if applicable, the Disclosed Principal’s personal information) may be disclosed by the Corporation to: (a) stock exchanges or securities regulatory authorities, (b) the Corporation’s registrar and transfer agent, (c) any government agency, board or other entity; and (d) any of the other parties involved in the Offering, including the Corporation, the Agent and their respective legal counsel, and may be included in record books in connection with the Offering. By executing this Subscription Agreement, the Subscriber on (and, if applicable, the Face Page identifying Disclosed Principal) is deemed to be consenting to the foregoing collection, use and disclosure of the Subscriber’s personal information (and, if applicable, the Disclosed Principal’s personal information). The Subscriber (and, if applicable, the Disclosed Principal) also consents to the filing of copies or originals of any of the documents described in Section 6.1(r) of this Subscription Agreement as may be required to be filed with any stock exchange or securities regulatory authority in connection with the transactions contemplated hereby and consents to the disclosure of such information to the public through the filing of a report of trade with applicable Securities Regulators. The Subscriber (and, if applicable, the Disclosed Principal) further acknowledges that it has been notified by the Corporation of and authorizes (a) the delivery to the Ontario Securities Commission (the “OSC”) of the full name, residential address and telephone number of the SubscriberSubscriber (and, whether if applicable, the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities LawsDisclosed Principal), the number and type of Units being purchased hereunder securities purchased, the total purchase price, the exemption relied upon and the Subscription Amount as well as the Closing Date and the exemption date of distribution; (b) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such this information is being collected indirectly collected by such Securities Regulators the OSC under the authority granted under Securities Laws. This to it in securities legislation; (c) that this information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario; and may be disclosed (d) that the Administrative Assistant to the public by such Director of Corporate Finance can be contacted at Ontario Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has Commission, Xxxxx 0000, Xxx 00, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, or at (000) 000-0000, regarding any questions with respect to about the OSC’s indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:information.

Appears in 1 contract

Samples: Subscription Agreement (Firstgold Corp.)

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Collection of Personal Information. The Subscriber hereby acknowledges that this Subscription Agreement and understands that: The Schedule “A” hereto require the Subscriber to provide certain personal information provided to the Corporation. Such information is being collected by the Corporation for the purposes of completing the Offering, which includes, without limitation, determining the Subscriber’s eligibility (or, if applicable, the eligibility of the Disclosed Principal) to purchase the Units under applicable securities legislation, preparing and registering certificates representing the Common Shares and Warrants to be issued hereunder and completing filings required by any stock exchange or securities regulatory authority. The Subscriber’s personal information (and, if applicable, the Disclosed Principal’s personal information) may be disclosed by the Corporation to: (a) stock exchanges or securities regulatory authorities, (b) the Corporation’s registrar and transfer agent, (c) any government agency, board or other entity; and (d) any of the other parties involved in the Offering, including the Corporation, the Agent and their respective legal counsel, and may be included in record books in connection with the Offering. By executing this Subscription Agreement, the Subscriber on (and, if applicable, the Face Page identifying Disclosed Principal) is deemed to be consenting to the foregoing collection, use and disclosure of the Subscriber’s personal information (and, if applicable, the Disclosed Principal’s personal information). The Subscriber (and, if applicable, the Disclosed Principal) also consents to the filing of copies or originals of any of the documents described in Section 5.1(r) of this Subscription Agreement as may be required to be filed with any stock exchange or securities regulatory authority in connection with the transactions contemplated hereby and consents to the disclosure of such information to the public through the filing of a report of trade with applicable Securities Regulators. The Subscriber (and, if applicable, the Disclosed Principal) further acknowledges that it has been notified by the Corporation of and authorizes (a) the delivery to the Ontario Securities Commission (the “OSC”) of the full name, residential address and telephone number of the SubscriberSubscriber (and, whether if applicable, the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities LawsDisclosed Principal), the number and type of Units being purchased hereunder securities purchased, the total purchase price, the exemption relied upon and the Subscription Amount as well as the Closing Date and the exemption date of distribution; (b) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such this information is being collected indirectly collected by such Securities Regulators the OSC under the authority granted under Securities Laws. This to it in securities legislation; (c) that this information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario; and may be disclosed (d) that the Administrative Assistant to the public by such Director of Corporate Finance can be contacted at Ontario Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has Commission, Xxxxx 0000, Xxx 00, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, or at (000) 000-0000, regarding any questions with respect to about the OSC’s indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:information.

Appears in 1 contract

Samples: Subscription Agreement (Firstgold Corp.)

Collection of Personal Information. The Subscriber hereby acknowledges This Subscription Agreement and understands that: The information provided by the schedules hereto require the Subscriber on to provide certain personal information (respecting the Face Page identifying Subscriber and, if applicable, the name, address and telephone number of the Subscriber, whether beneficial purchaser for whom the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed contracting) to the Securities Regulators, and such Company. (Personal information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s includes “personal information (information” as that term is defined under applicable privacy legislation, including, including without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, similar replacement or supplemental provincial or federal legislation or laws and the policies of the TSXV in effect from time to time). Such information is being collected for the purposes of completing the Offering, or that which includes, without limitation, determining the eligibility of each the Subscriber or, if applicable, the beneficial purchaser for whom it the Subscriber is contracting hereundercontracting, to purchase the Securities under applicable securities laws, preparing and registering certificates representing the Securities to be issued hereunder and completing filings required under applicable Securities Laws or by any stock exchange, the Investment Industry Regulatory Organization of Canada and/or securities regulatory authorities. In addition, such personal information may be used or disclosed by the Company for the purpose of completing administering the Company’s relationship with the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting. For example, such personal information may be used by the Company to communicate with the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting (such as by providing annual or quarterly reports), to prepare tax filings and forms or to comply with its obligations under taxation, securities and other laws (such as maintaining a list of holders of shares). In connection with the foregoing, the personal information of the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting, may be disclosed by the Company to: (i) any stock exchanges or securities regulatory or taxation authorities; (ii) the Company’s registrar and Transfer Agent (if applicable); and (iii) any of the other parties involved in the Offering, including legal counsel, and may be included in record books prepared in respect of the Offering. By executing this Subscription Agreement, the Subscriber (on its own behalf and, if applicable, on behalf of the beneficial purchaser for whom the Subscriber is contracting) hereby consents to the collection, use and disclosure of such personal information. The Subscriber (on its own behalf and, if applicable, on behalf of the beneficial purchaser for whom the Subscriber is contracting) also consents to the filing of copies or originals of any of the documents provided to the Company by or on behalf of the Subscriber with any securities regulatory authority in relation to the transactions contemplated by this Subscription. The Subscriber acknowledges and consents agrees that the Subscriber has been notified by the Company: (i) of the delivery to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents Securities Commissions of Personal Information pertaining to the fact Subscriber, including, without limitation, the full name, residential address and telephone number of the Subscriber, the number and type of securities purchased and the total purchase price paid in respect of the purchased securities; (ii) that this information is being collected indirectly by the securities commissions under the authority granted to them under securities legislation; (iii) that this information is being collected for the purposes of the administration and enforcement of the securities legislation of Canada; and (iv) that the Manager and/or title, business address and business telephone number of the Fund may public official of each of the securities commissions who can answer questions about the indirect collection of Personal Information is attached hereto as Schedule D. SCHEDULE A UNITED STATES SUBSCRIPTION AGREEMENT AND QUESTIONNAIRE Provided Separately SUBSCRIBER INFORMATION SHEET INFORMATION TO BE COMPLETED BY THE SUBSCRIBER: A Registration Form The Subscriber, if not an individual and (i) if a member of the “Pro Group” (as described below), or (ii) if (or will be required by after completion of the Securities Laws Offering) an “Insider” (as described below), or (iii) will be a holder of more than 5% of the listed shares after completion of the Offering, either [check appropriate box]: has previously filed with the TSX Venture Exchange (the “TSXV”) a Form 4C, Corporate Placee Registration Form, represents and warrants that there has been no change to any of the rules and policies of any stock exchange to provide regulatory authorities information in the Corporate Placee Registration Form previously filed with any personal information provided by the Subscriber in this Subscription Agreement. In addition TSXV up to the foregoingdate hereof; or hereby delivers a completed Form 4C, Corporate Placee Registration Form, in the Subscriber agrees and acknowledges that form attached as Appendix A to this Schedule B to the Manager and/or Company for filing with the Fund may use and disclose its personal information as follows:TSXV.

Appears in 1 contract

Samples: Unit Purchase Agreement

Collection of Personal Information. The Subscriber hereby acknowledges This Subscription Agreement and understands that: The information provided by the schedules hereto require the Subscriber on to provide certain personal information (respecting the Face Page identifying Subscriber and, if applicable, the name, address and telephone number of the Subscriber, whether beneficial purchaser for whom the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed contracting) to the Securities Regulators, and such Corporation. (Personal information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s includes “personal information (information” as that term is defined under applicable privacy legislation, including, including without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, similar replacement or supplemental provincial or federal legislation or laws and the policies of the TSX in effect from time to time). Such information is being collected for the purposes of completing the Offering, or that which includes, without limitation, determining the eligibility of each the Subscriber or, if applicable, the beneficial purchaser for whom it the Subscriber is contracting hereundercontracting, to purchase the Common Shares under applicable Securities Laws, preparing and registering certificates representing the Common Shares to be issued hereunder and completing filings required under applicable Securities Laws or by any stock exchange, the Investment Industry Regulatory Organization of Canada and/or other securities regulatory authorities. In addition, such personal information may be used or disclosed by the Corporation for the purpose of completing administering the Corporation’s relationship with the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting. For example, such personal information may be used by the Corporation to communicate with the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting (such as by providing annual or quarterly reports), to prepare tax filings and forms or to comply with its obligations under taxation, securities and other laws (such as maintaining a list of holders of shares). In connection with the foregoing, the personal information of the Subscriber or, if applicable, the beneficial purchaser for whom the Subscriber is contracting, may be disclosed by the Corporation to: (i) any stock exchanges or securities regulatory or taxation authorities; (ii) the Corporation’s registrar and transfer agent (if applicable); and (iii) any of the other parties involved in the Offering, including legal counsel, and may be included in record books prepared in respect of the Offering. By executing this Subscription Agreement, the Subscriber (on its own behalf and, if applicable, on behalf of the beneficial purchaser for whom the Subscriber is contracting) hereby consents to the collection, use and disclosure of such personal information. The Subscriber (on its own behalf and, if applicable, on behalf of the beneficial purchaser for whom the Subscriber is contracting) also consents to the filing of copies or originals of any of the documents provided to the Corporation by or on behalf of the Subscriber with any securities regulatory authority in relation to the transactions contemplated by this Subscription. The Subscriber acknowledges that the Subscriber’s personal information and the personal information of any Disclosed Principal may be delivered to the Ontario Securities Commission and is thereby being collected indirectly by the Ontario Securities Commission under the authority granted to it in securities legislation for the purposes of administration and enforcement of the securities legislation of Ontario. The public official in Ontario who can answer questions about the Ontario Securities Commission’s indirect collection of personal information is: Administrative Support Clerk, Suite 1903, Box 50, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx, X0X 0X0, Telephone (000) 000-0000. The Subscriber further acknowledges that the Subscriber’s personal information and the personal information of any Disclosed Principal may be delivered to the British Columbia Securities Commission and is thereby being collected indirectly by the British Columbia Securities Commission for the purposes of administration and enforcement of the securities legislation of British Columbia. (Information may be publicly disclosed or made available by the British Columbia Securities Commission, including the name of the Subscriber (or Disclosed Principal), whether such person is an insider or registrant, the number of securities purchased and, in the case of certain non-individual Subscribers, their addresses, telephone numbers and prospectus exemptions relied upon). Questions about British Columbia’s Securities Commission’s indirect collection of personal information may be directed to: British Columbia Securities Commission, P.O. Box 10142, Pacific Centre, 700 Xxxx Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxx Xxxxxxxx, X0X 0X0, Telephone (000) 000-0000, Toll free across Canada 1-000-000-0000, Facsimile (000) 000-0000. The Subscriber also acknowledges and consents to the collection, use and disclosure of the Subscriber’s personal information by the TSX and its affiliates, authorized agents, subsidiaries and divisions, including the TSX for the following purposes: (i) to conduct background checks; (ii) to verify personal information that has been provided about each individual; (iii) to provide disclosure to market participants as to the security holdings of directors, officers, other insiders and promoters of the Corporation or its associates or affiliates; (iv) to conduct enforcement proceedings; and (v) to perform other investigations as required by and to ensure compliance with all applicable rules, policies, rulings and regulations of the TSX, Canadian Securities Laws and other legal and regulatory requirements governing the conduct and protection of the public markets in Canada. As part of this process, the Subscriber further acknowledges that the TSX also collects additional personal information from other sources, including but not limited to, securities regulatory authorities in Canada or elsewhere, investigative, law enforcement or self-regulatory organizations, regulations services providers and each of their subsidiaries, affiliates, regulators and authorized agents, to ensure that the purposes set out above can be accomplished. The personal information collected by the TSX may also be disclosed: (i) to the aforementioned agencies and organizations or as otherwise permitted or required by law and may be used for the purposes described above for their own investigations, and (ii) on the TSX’s website or through printed materials published by or pursuant to the directions of the TSX. The TSX may from time to time use third parties to process information and/or provide other administrative services and may share information with such third party services providers. SCHEDULE A UNITED STATES SUBSCRIBERS REPRESENTATION LETTER This Representation Letter is being delivered in connection with the execution and delivery of the Subscription Agreement of the undersigned subscriber (the “Subscriber”) in connection with the purchase of common shares (the “Common Shares”) of Acerus Pharmaceuticals Corporation (the “Corporation”). Capitalized terms used herein and not defined herein will have the meanings ascribed thereto in the Subscription Agreement. The Subscriber acknowledges represents, warrants and consents covenants to the Manager and/or Corporation (which representations, warranties and covenants will survive the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies Closing Date) on its own behalf and, if applicable, on behalf of any stock exchange to provide regulatory authorities with any personal information provided by beneficial purchaser for whom the Subscriber in this Subscription Agreement. In addition is contracting hereunder to and with the foregoing, the Subscriber agrees Corporation and acknowledges that the Manager and/or the Fund may use Corporation and disclose its personal information as followscounsel are relying thereon that:

Appears in 1 contract

Samples: Subscription Agreement (Aytu Bioscience, Inc)

Collection of Personal Information. The Subscriber hereby acknowledges that this Subscription Agreement and understands that: The Schedules hereto require the Subscriber to provide certain personal information provided to the Corporation. Such information is being collected by the Corporation for the purposes of completing the Offering, which includes, without limitation, determining the Subscriber’s eligibility (or, if applicable, the eligibility of the disclosed beneficial purchaser) to purchase the Units under applicable Securities Laws, preparing and registering certificates representing the Securities to be issued hereunder and completing filings required by any stock exchange or securities regulatory authority. The Subscriber’s personal information (and, if applicable, the disclosed beneficial purchaser’s personal information) may be disclosed by the Corporation to: (a) stock exchanges or securities regulatory authorities, (b) the Corporation’s registrar and transfer agent, (c) any government agency, board or other entity; and (d) any of the other parties involved in the Offering, including the Corporation, the Agents and their respective legal counsel, and may be included in record books in connection with the Offering. By executing this Subscription Agreement, the Subscriber on (and, if applicable, the Face Page identifying disclosed beneficial purchaser) is deemed to be consenting to the foregoing collection, use and disclosure of the Subscriber’s personal information (and, if applicable, the disclosed beneficial purchaser’s personal information). The Subscriber (and, if applicable, the disclosed beneficial purchaser) also consents to the filing of copies or originals of any of the documents described in this Subscription Agreement as may be required to be filed with any stock exchange or securities regulatory authority in connection with the transactions contemplated hereby and consents to the disclosure of such information to the public through the filing of a report of trade with applicable Securities Regulators. The Subscriber (and, if applicable, the disclosed beneficial purchaser) further acknowledges that it has been notified by the Corporation of and authorizes (a) the delivery to the OSC of the full name, residential address and telephone number of the SubscriberSubscriber (and, whether if applicable, the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawsdisclosed beneficial purchaser), the number and type of Units being purchased hereunder securities purchased, the total purchase price, the exemption relied upon and the Subscription Amount as well as the Closing Date and the exemption date of distribution; (b) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such this information is being collected indirectly collected by such Securities Regulators the OSC under the authority granted under Securities Laws. This to it in securities legislation; (c) that this information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario; and may be disclosed (d) that the Administrative Assistant to the public by such Director of Corporate Finance can be contacted at Ontario Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has Commission, Xxxxx 0000, Xxx 00, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, or at (000) 000-0000, regarding any questions with respect to about the OSC’s indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:information.

Appears in 1 contract

Samples: Rockwell Ventures Inc

Collection of Personal Information. The Subscriber hereby acknowledges and understands that: The information provided by the Subscriber on the Face Page identifying the name, address and telephone number of the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder This Agreement and the Subscription Amount as well as schedules hereto require the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed Lender to the Securities Regulators, and such information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s provide certain personal information (respecting the Lender) to the Corporation. (Personal information includes “personal information” as that term is defined under applicable privacy legislation, including, including without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, similar replacement or supplemental provincial or federal legislation or laws and the policies of the CSE in effect from time to time). Such information is being collected for the purposes of completing the conversion of the Converted Debt into Payment Shares, which includes, without limitation, determining the eligibility of the Lender to acquire the Payment Shares under applicable securities laws, preparing and registering certificates representing the Payment Shares to be issued hereunder and completing filings required under applicable Securities Laws or that by any stock exchange, the Investment Industry Regulatory Organization of each beneficial purchaser for whom it is contracting hereunderCanada and/or securities regulatory authorities. In addition, such personal information may be used or disclosed by the Corporation for the purpose of completing this Subscription Agreementadministering the Corporation’s relationship with the Lender. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining For example, such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required used by the Securities Laws Corporation to communicate with the Lender (such as by providing annual or quarterly reports), to prepare tax filings and the rules forms or to comply with its obligations under taxation, securities and policies other laws (such as maintaining a list of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreementholders of shares). In addition to connection with the foregoing, the Subscriber agrees personal information of the Lender may be disclosed by the Corporation to: (i) any stock exchanges or securities regulatory or taxation authorities; (ii) the Corporation’s registrar and transfer agent (if applicable); and (iii) any of the other parties involved in the conversion of the Converted Debt into Payment Shares, including legal counsel, and may be included in record books prepared in respect of the transaction. By executing this Agreement, the Lender hereby consents to the collection, use and disclosure of such personal information. The Lender also consents to the filing of copies or originals of any of the documents provided to the Corporation by or on behalf of the Lender with any securities regulatory authority in relation to the transactions contemplated by this Agreement. The Lender acknowledges that the Manager and/or the Fund may use and disclose its Lender’s personal information as follows:may be delivered to the Ontario Securities Commission and is thereby being collected indirectly by the Ontario Securities Commission under the authority granted to it in securities legislation for the purposes of administration and enforcement of the securities legislation of Ontario. The public official in Ontario who can answer questions about the Ontario Securities Commission’s indirect collection of personal information is: Administrative Support Clerk to the Director of Corporate Finance, Suite 1903, Box 0000, Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx, X0X 0X0, Telephone (000) 000 0000.

Appears in 1 contract

Samples: Conversion of Debt Agreement

Collection of Personal Information. The By executing this Subscription Agreement, the Subscriber hereby acknowledges consents to the collection, use and understands that: The disclosure of the personal information provided herein and other personal information provided by the Subscriber or collected by the Corporation or its agents as reasonably necessary in connection with the Subscriber’s subscription for the Subscribed Shares (collectively, "personal information") as follows: (a) the Corporation may use personal information and disclose personal information to intermediaries such as the Corporation’s legal counsel and withholding and/or transfer agents for the purposes of determining the Subscriber’s eligibility to invest in the Subscribed Shares and for managing and administering the Subscriber’s investment in the Subscribed Shares; (b) if the Subscriber purchased securities through a registered dealer, the Corporation may disclose and collect such personal information relating to the Subscriber’s holding of the Subscribed Shares to and from the dealer; (c) the Corporation and its agents may use the Subscriber’s social insurance number for income reporting purposes in accordance with applicable law; (d) the Corporation, its agents and advisors, may each collect, use and disclose personal information for the purposes of meeting legal, regulatory, self-regulatory, security and audit requirements (including any applicable tax, securities, money laundering or anti-terrorism legislation, rules or regulations) and as otherwise permitted or required by law, which disclosures may include disclosures to tax, securities or other regulatory or self-regulatory authorities in Canada and/or in foreign jurisdictions, if applicable, in connection with the regulatory oversight mandate of such authorities; (e) the Corporation and its agents and advisors may use personal information and disclose personal information to parties connected with the proposed or actual transfer, sale, assignment, merger or amalgamation of the Corporation or its business or assets or similar transactions, for the purpose of permitting such parties to evaluate and/or proceed with and complete such transaction. Purchasers, assignees and successors of the Corporation or its business or assets may collect, use and disclose personal information as described in this Subscription Agreement. The Subscriber acknowledges that the Corporation’s agents or intermediaries may be located outside of Canada, and personal information may be transferred and/or processed outside of Canada for the purposes described above, and that measures the Issuer may use to protect personal information while handled by agents, intermediaries or other third parties on its behalf, and personal information otherwise disclosed or transferred outside of Canada for the Face Page identifying purposes described above, are subject to legal requirements in foreign countries applicable to Issuer or such third parties, for example lawful requirements to disclose personal information to government authorities in those countries. If the Subscriber is resident in, or otherwise subject to the applicable securities legislation of Ontario, the Subscriber acknowledges (i) the delivery to the Ontario Securities Commission of the Subscriber’s full name, residential address and telephone number, the number and type of securities purchased by the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawstotal purchase price, the number of Units being purchased hereunder exemption relied on, and the Subscription Amount as well as the Closing Date and the exemption date of distribution, (ii) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being collected indirectly collected by such the Ontario Securities Regulators Commission under the authority granted under Securities Laws. This to it in securities legislation, (iii) that such information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario, and may be disclosed (iv) that the Administrative Assistant to the public by Director of Corporate Finance at the Ontario Securities Commission, Xxxxx 0000, Xxx 00, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, telephone (000) 000-0000, can be contacted to answer questions about the Ontario Securities Commission’s indirect collection of such Securities Regulators in accordance with securities legislationinformation. Each The Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Ontario Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:Commission.

Appears in 1 contract

Samples: Subscription Agreement (Apollo Gold Corp)

Collection of Personal Information. The By executing this Subscription Agreement, the Subscriber hereby acknowledges consents to the collection, use and understands that: The disclosure of the personal information provided herein and other personal information provided by the Subscriber or collected by the Corporation or its agents as reasonably necessary in connection with the Subscriber’s subscription for the Subscribed Shares (collectively, “personal information”) as follows: (a) the Corporation may use personal information and disclose personal information to intermediaries such as the Corporation’s legal counsel and withholding and/or transfer agents for the purposes of determining the Subscriber’s eligibility to invest in the Subscribed Shares and for managing and administering the Subscriber’s investment in the Subscribed Shares; (b) if the Subscriber purchased securities through a registered dealer, the Corporation may disclose and collect such personal information relating to the Subscriber’s holding of the Subscribed Shares to and from the dealer; (c) the Corporation and its agents may use the Subscriber’s social insurance number for income reporting purposes in accordance with applicable law; (d) the Corporation, its agents and advisors, may each collect, use and disclose personal information for the purposes of meeting legal, regulatory, self-regulatory, security and audit requirements (including any applicable tax, securities, money laundering or anti-terrorism legislation, rules or regulations) and as otherwise permitted or required by law, which disclosures may include disclosures to tax, securities or other regulatory or self-regulatory authorities in Canada and/or in foreign jurisdictions, if applicable, in connection with the regulatory oversight mandate of such authorities; (e) the Corporation and its agents and advisors may use personal information and disclose personal information to parties connected with the proposed or actual transfer, sale, assignment, merger or amalgamation of the Corporation or its business or assets or similar transactions, for the purpose of permitting such parties to evaluate and/or proceed with and complete such transaction. Purchasers, assignees and successors of the Corporation or its business or assets may collect, use and disclose personal information as described in this Subscription Agreement. The Subscriber acknowledges that the Corporation’s agents or intermediaries may be located outside of Canada, and personal information may be transferred and/or processed outside of Canada for the purposes described above, and that measures the Issuer may use to protect personal information while handled by agents, intermediaries or other third parties on its behalf, and personal information otherwise disclosed or transferred outside of Canada for the Face Page identifying purposes described above, are subject to legal requirements in foreign countries applicable to Issuer or such third parties, for example lawful requirements to disclose personal information to government authorities in those countries. If the Subscriber is resident in, or otherwise subject to the applicable securities legislation of Ontario, the Subscriber acknowledges (i) the delivery to the Ontario Securities Commission of the Subscriber’s full name, residential address and telephone number, the number and type of securities purchased by the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Lawstotal purchase price, the number of Units being purchased hereunder exemption relied on, and the Subscription Amount as well as the Closing Date and the exemption date of distribution, (ii) that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being collected indirectly collected by such the Ontario Securities Regulators Commission under the authority granted under Securities Laws. This to it in securities legislation, (iii) that such information is being collected for the purposes of the administration and enforcement of the Securities Laws securities legislation of Ontario, and may be disclosed (iv) that the Administrative Assistant to the public by Director of Corporate Finance at the Ontario Securities Commission, Xxxxx 0000, Xxx 00, 00 Xxxxx Xxxxxx Xxxx, Xxxxxxx, Xxxxxxx X0X 0X0, telephone (000) 000-0000, can be contacted to answer questions about the Ontario Securities Commission’s indirect collection of such Securities Regulators in accordance with securities legislationinformation. Each The Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Ontario Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereunder, for the purpose of completing this Subscription Agreement. The Subscriber acknowledges and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by the Securities Laws and the rules and policies of any stock exchange to provide regulatory authorities with any personal information provided by the Subscriber in this Subscription Agreement. In addition to the foregoing, the Subscriber agrees and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:Commission.

Appears in 1 contract

Samples: Subscription Agreement (Apollo Gold Corp)

Collection of Personal Information. The By executing this Subscription Agreement, the Subscriber hereby acknowledges consents to the collection, use and understands that: The disclosure of the personal information provided herein and other personal information provided by the Subscriber on or collected by the Face Page identifying the name, address and telephone number of Corporation or its agents as reasonably necessary in connection with the Subscriber's subscription for the Subscribed Shares (collectively, whether "personal information") as follows: (a) the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder Corporation may use personal information and the Subscription Amount as well disclose personal information to intermediaries such as the Closing Date Corporation's legal counsel and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected withholding and/or transfer agents for the purposes of determining the administration Subscriber's eligibility to invest in the Subscribed Shares and enforcement for managing and administering the Subscriber's investment in the Subscribed Shares; (b) if the Subscriber purchased securities through a registered dealer, the Corporation may disclose and collect such personal information relating to the Subscriber's holding of the Securities Laws Subscribed Shares to and from the dealer; (c) the Corporation and its agents may be disclosed to use the public by such Securities Regulators Subscriber's social security number for income reporting purposes in accordance with applicable law; (d) the Corporation, its agents and advisors, may each collect, use and disclose personal information for the purposes of meeting legal, regulatory, self-regulatory, security and audit requirements (including any applicable tax, securities, money laundering or anti-terrorism legislation, rules or regulations) and as otherwise permitted or required by law, which disclosures may include disclosures to tax, securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities or other regulatory or self-regulatory authorities in each Canada, the United States and/or in foreign jurisdictions, if applicable, in connection with the regulatory oversight mandate of such authorities; (e) the Corporation and its agents and advisors may use personal information and disclose personal information to parties connected with the proposed or actual transfer, sale, assignment, merger or amalgamation of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents to the fact that the Fund and/or the Manager is collecting the Subscriber’s personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement Corporation or supplemental provincial its business or federal legislation assets or laws in effect from time to time), or that of each beneficial purchaser for whom it is contracting hereundersimilar transactions, for the purpose of completing permitting such parties to evaluate and/or proceed with and complete such transaction. Purchasers, assignees and successors of the Corporation or its business or assets may collect, use and disclose personal information as described in this Subscription Agreement. The Subscriber acknowledges that the Corporation's agents or intermediaries may be located outside of United States, and consents to the Manager and/or the Fund retaining such personal information for as long as permitted or required by law or business practices. The Subscriber further acknowledges and consents to the fact that the Manager and/or the Fund may be required by transferred and/or processed outside of the Securities Laws United States for the purposes described above, and that measures the rules and policies of any stock exchange Corporation may use to provide regulatory authorities with any protect personal information provided while handled by the Subscriber in this Subscription Agreement. In addition to the foregoingagents, the Subscriber agrees intermediaries or other third parties on its behalf, and acknowledges that the Manager and/or the Fund may use and disclose its personal information as follows:otherwise disclosed or transferred outside of the United States for the purposes described above, are subject to legal requirements in foreign countries applicable to Corporation or such third parties; for example lawful requirements to disclose personal information to government authorities in those countries.

Appears in 1 contract

Samples: Rights Agreement (Apollo Gold Corp)

Collection of Personal Information. The Subscriber hereby acknowledges I, on my own behalf and, if applicable, on behalf of each beneficial purchaser for whom I am contracting hereunder, acknowledge and understands that: The information provided by the Subscriber on the Face Page identifying the name, address and telephone number of the Subscriber, whether the Subscriber is an “insider” of the Fund and/or a “registrant” as each term is defined under the Securities Laws, the number of Units being purchased hereunder and the Subscription Amount as well as the Closing Date and the exemption that the Subscriber is relying on in purchasing the Units will be disclosed to the Securities Regulators, and such information is being indirectly collected by such Securities Regulators under the authority granted under Securities Laws. This information is being collected for the purposes of the administration and enforcement of the Securities Laws and may be disclosed to the public by such Securities Regulators in accordance with securities legislation. Each Subscriber hereby authorizes the indirect collection and disclosure of such information by the applicable securities regulatory authorities in each of the jurisdictions in which the offering of Units is made. In the event the Subscriber has any questions with respect to the indirect collection of such information by the Securities Regulator, the Subscriber should contact the appropriate Securities Regulator at set out in Appendix VII – Contact Information for the Canadian Securities Regulatory Authorities. The Subscriber acknowledges and consents consent to the fact that the Fund and/or the Manager Company is collecting the Subscriber’s our personal information (as that term is defined under applicable privacy legislation, including, without limitation, the Personal Information Protection and Electronic Documents Act (Canada) and any other applicable similar, replacement or supplemental provincial or federal legislation or laws in effect from time to time), or and, if applicable, that of each beneficial purchaser for whom it is I am contracting hereunder, for the purpose of completing this Subscription AgreementAgreement and the transaction contemplated herein. The Subscriber acknowledges I, on my own behalf, and, if applicable, on behalf of each beneficial purchaser for whom I am contracting hereunder, acknowledge and consents consent to the Manager and/or the Fund Company retaining such personal information for as long as permitted or required by law or business practices. The Subscriber I, on my own behalf, and, if applicable, on behalf of each beneficial purchaser for whom I am contracting hereunder, further acknowledges acknowledge and consents consent to the fact that the Manager and/or the Fund Company may be required by the Canadian Securities Laws and Laws, the rules and policies of any stock exchange or the rules of the Investment Industry Regulatory Organization of Canada or otherwise by applicable law to provide regulatory authorities with any personal information provided by under this Agreement. I represent and warrant, as applicable, that I have the Subscriber authority to provide the consents and acknowledgements set out in this Subscription Agreementparagraph on behalf of each beneficial purchaser for whom I am contracting hereunder. In addition to the foregoing, the Subscriber agrees I agree and acknowledges acknowledge that the Manager and/or the Fund Company may use and disclose its my personal information information, or that of each beneficial purchaser for whom I am contracting hereunder, as follows:: ● for internal use with respect to managing the relationships between and contractual obligations of the Company and me or any beneficial purchaser for whom I am contracting hereunder; ● for use and disclosure for income tax related purposes, including without limitation, where required by law, disclosure to Canada Revenue Agency; ● for disclosure to stock exchanges, securities regulatory authorities and other regulatory bodies with jurisdiction with respect to reports of trades and similar regulatory filings; ● for disclosure to a governmental or other authority to which the disclosure is required by court order or subpoena compelling such disclosure and where there is no reasonable alternative to such disclosure; ● for disclosure to professional advisers of the Corporation in connection with the performance of their professional services; ● for disclosure to any person where such disclosure is necessary for legitimate business reasons and is made with my prior written consent; ● for disclosure to a court determining the rights of the parties under this Agreement; or ● for use and disclosure as otherwise required or permitted by law. The information provided by me in this Agreement identifying my name, address, and telephone number, the number of Securities being purchased hereunder, the aggregate purchase price and the closing date, will be disclosed to the securities regulatory authority or regulator in each of the provinces and territories of Canada in which Securities are distributed by the Company, and such information is being collected by such securities regulatory authorities and regulators under the authority granted to each of them under securities legislation. This information is being collected for the purposes of the administration and enforcement of the securities legislation of such selling jurisdictions. I hereby authorize the indirect collection of such information by such securities regulatory authorities and regulators. In the event I have any questions with respect to the indirect collection of such information by such securities regulatory authorities and regulators, I should contact the applicable securities regulatory authority or regulator using the contact information set out below: ● British Columbia Securities Commission, P.O. Box 10142, Pacific Centre, 000 Xxxx Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxx Xxxxxxxx X0X 0X0, Inquiries: (000) 000-0000, Toll free in Canada: 0-000-000-0000, Facsimile: (000) 000-0000, Email: xxxxxxxxx@xxxx.xx.xx; ● Alberta Securities Commission, Suite 600, 250 – 5th Street, SW Calgary, Alberta T2P 0R4, Telephone: (000) 000-0000, Toll free in Canada: 0-000-000-0000, Facsimile: (000) 000-0000; ● Financial and Consumer Affairs Authority of Saskatchewan, Suite 601 - 0000 Xxxxxxxxxxxx Xxxxx, Xxxxxx, Xxxxxxxxxxxx X0X 0X0, Telephone: (000) 000-0000, Facsimile: (000) 000-0000; ● The Manitoba Securities Commission, 500 – 000 Xx. Xxxx Xxxxxx, Winnipeg, Manitoba R3C 4K5, Telephone: (000) 000-0000, Toll free in Manitoba 0-000-000-0000, Facsimile: (000) 000-0000; ● Ontario Securities Commission, 00 Xxxxx Xxxxxx Xxxx, 00xx Xxxxx Xxxxxxx, Xxxxxxx X0X 0X0, Telephone: (416) 000- 0000, Toll free in Canada: 0-000-000-0000, Facsimile: (000) 000-0000, Email: xxxxxxxxxxxxxxxxxxx@xxx.xxx.xx.xx, Public official contact regarding indirect collection of information: Inquiries Officer; ● Autorité des marchés financiers, 000, Xxxxxx Xxxxxxxx, 00x étage, X.X. 000, Xxxx xx xx Xxxxxx, Xxxxxxxx, Xxxxxx X0X 0X0, Telephone: (000) 000-0000 or 0-000-000-0000, Facsimile: (000) 000-0000 (For filing purposes only), Facsimile: (000) 000-0000 (For privacy requests only), Email: xxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxx.xx.xx (For corporate finance issuers); xxxxx_xxxxxxxxxxxxxxx@xxxxxxxxx.xx.xx (For investment fund issuers); ● Financial and Consumer Services Commission (New Brunswick), 00 Xxxxxxxxx Xxxxxx,, Xxxxx 000 Xxxxx Xxxx, New Brunswick E2L 2J2, Telephone: (000) 000-0000, Toll free in Canada: 0-000-000-0000, Facsimile: (000) 000-0000, Email: xxxx@xxxx.xx ● Nova Scotia Securities Commission, Xxxxx 000, 0000 Xxxx Xxxxxx, Xxxx Tower, X.X. Xxx 000 Xxxxxxx, Xxxx Xxxxxx X0X 0X0, Telephone: (000) 000-0000, Facsimile: (000) 000-0000; ● Xxxxxx Xxxxxx Island Securities Office, 00 Xxxxxxxx Xxxxxx, 4th Floor Xxxx Building, P.O. Box 2000 Charlottetown, Xxxxxx Xxxxxx Island C1A 7N8, Telephone: (000) 000-0000, Facsimile: (000) 000-0000; ● Government of Newfoundland and Labrador, Financial Services Regulation Division, X.X. Xxx 0000, Xxxxxxxxxxxxx Xxxxxxxx 0xx Xxxxx, Xxxx Block, Xxxxxx Xxxxxx Drive, St. John’s, Newfoundland and Labrador A1B 4J6, Attention: Director of Securities, Telephone: (000) 000-0000, Facsimile: (000) 000-0000; ● Government of Yukon, Department of Community Services Law Centre, 3rd Floor, 0000 Xxxxxx Xxxxxx, Xxxxxxxxxx, Xxxxx X0X 0X0, Telephone: (000) 000-0000, Facsimile: (000) 000-0000; ● Government of the Northwest Territories, Office of the Superintendent of Securities, X.X. Xxx 0000 Xxxxxxxxxxx, Xxxxxxxxx Xxxxxxxxxxx X0X 0X0 Attention: Deputy Superintendent, Legal & Enforcement, Telephone: (000) 000-0000, Facsimile: (000) 000-0000; and ● Government of Nunavut, Department of Justice, Legal Registries Division, P.O. Box 1000, Station 000, 0xx Xxxxx, Xxxxx Xxxxxxxx, Xxxxxxx, Xxxxxxx X0X 0X0, Telephone: (000) 000-0000, Facsimile: (000) 000-0000.

Appears in 1 contract

Samples: Subscription Agreement (Droneify Holdings LTD)

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