FORM 13-502F3A
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FORM 13-502F3A
CLASS 3A REPORTING ISSUERS -- PARTICIPATION FEE
Reporting Issuer Name: _________________________ |
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Fiscal year end date: |
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Indicate, by checking the appropriate box, which of the following criteria the issuer meets: |
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(a) The issuer has no securities listed or quoted on a marketplace located anywhere in the world; or |
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(b) the issuer has securities listed or quoted on a marketplace anywhere in the world and |
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at the end of its previous fiscal year, securities registered in the names of persons or companies resident in Ontario represented less than 1% of the market value of all outstanding securities of the reporting issuer for which the reporting issuer or its transfer agent or registrar maintains a list of registered owners, |
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the reporting issuer reasonably believes that persons or companies who are resident in Ontario beneficially own less than 1% of the market value of all outstanding securities of the reporting issuer, |
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the reporting issuer reasonably believes that no security of the reporting issuer traded on a marketplace in Canada during its previous fiscal year, and |
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the reporting issuer has not issued any of its securities in Ontario in the last 5 years, other than to |
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(A) |
employees of the reporting issuer or employees of a subsidiary entity of the reporting issuer, or |
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(B) |
pursuant to the exercise of a right previously granted by the reporting issuer or its affiliate to convert or exchange previously issued securities of the issuer without payment of any additional consideration. |
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Participation Fee |
$600 |
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(From subsection 2.2(2) of the Rule) |
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New reporting issuer's reduced participation fee, if applicable |
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(See section 2.6 of the Rule) |
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Participation fee |
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Number of entire months remaining |
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in the issuer's fiscal year |
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_____________________________________________________ |
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12 |
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Late Fee, if applicable |
__________ |
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(As determined under section 2.5 of the Rule) |
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