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Sample interim certificate permitted to be filed for permitted interim periods Form 52-109F2 - Certification of Interim Filings
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Sample interim certificate permitted to be filed
for permitted interim periods
Form 52-109F2 - Certification of Interim Filings
I, ‹identify the certifying officer, the issuer, and his or her position at the issuer›, certify that:
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I have reviewed the interim filings (as this term is defined in Multilateral Instrument 52-109 Certification of Disclosure in Issuers' Annual and Interim Filings) of <identify the issuer>, (the issuer) for the interim period ending <state the relevant date>;
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Based on my knowledge, the interim filings do not contain any untrue
statement of a material fact or omit to state a material fact required
to be stated or that is necessary to make a statement not misleading in
light of the circumstances under which it was made, with respect to the
period covered by the interim filings;
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Based on my knowledge, the interim financial statements together with
the other financial information included in the interim filings fairly
present in all material respects the financial condition, results of
operations and cash flows of the issuer, as of the date and for the
periods presented in the interim filings;
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The issuer's other certifying officers and I are responsible for
establishing and maintaining disclosure controls and procedures
and internal control over financial reporting for the issuer, and we have:
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designed such disclosure controls and procedures, or caused them to be
designed under our supervision, to provide reasonable assurance that
material information relating to the issuer, including its consolidated
subsidiaries, is made known to us by others within those entities,
particularly during the period in which the interim filings are being
prepared; and
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designed such internal control over financial reporting, or caused it to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with the issuer's GAAP; and
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I have caused the issuer to disclose in the interim MD&A any change in the issuer's internal control over financial reporting that occurred during the issuer's most recent interim period that has materially affected, or is reasonably likely to materially affect, the issuer's internal control over financial reporting.
Date: ...............
_______________________
[Signature]
[Title]
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