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Osisko Development Corp. — Regulatory Filings 2021
Jan 18, 2021
45981_rns_2021-01-18_bb195b57-01ab-4f1f-97b2-0bd5ec1efb99.pdf
Regulatory Filings
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Form 45-106F1 Report of Exempt Distribution (Non-investment fund issuer)
ITEM 1 – REPORT TYPE
New report
Amended report If amended, provide Submission ID of report that is being amended: (Example: EDR1234567890-123)
ITEM 2 – PARTY CERTIFYING THE REPORT
Indicate the party certifying the report (select only one). For guidance regarding whether an issuer is an investment fund, refer to section 1.1 of National Instrument 81-106 Investment Fund Continuous Disclosure and the companion policy to NI 81-106.
Issuer (Other than an investment fund)
Underwriter
ITEM 3 – ISSUER NAME AND OTHER IDENTIFIERS
Provide the following information about the issuer, or if the issuer is an investment fund, about the fund.
Full legal name
Osisko Development Corp.
Previous full legal name If the issuer's name changed in the last 12 months, provide most recent previous legal name.
Website (if applicable)
If the issuer has a legal entity identifier, provide below. Refer to Part B of the Instructions for the definition of "legal entity identifier".
Legal entity identifier
Did two or more co-issuers distribute a single security? No Yes
If two or more issuers distributed a single security, provide the full legal name(s) of the co-issuer(s) other than the issuer named above.
Full legal name(s) of co-issuer(s)
ITEM 4 – UNDERWRITER INFORMATION
| If an underwriter is completing the report, provide the underwriter's full legal name and firm NRD number. | ||||
|---|---|---|---|---|
| Full legal name | ||||
| Does the Underwriter's Firm have an NRD Number?NoYes | Firm NRD number | |||
| If the underwriter does not have a firm NRD number, provide the head office contact information of the underwriter. | ||||
| Street address | Municipality | Province/State | Postal/ZIP code | |
| Country | Telephone number | Website (if applicable) | ||
| ITEM 5 – ISSUER INFORMATION | |||
|---|---|---|---|
| a) Primary industry | |||
| Provide the issuer's North American Industry Classification Standard (NAICS) code (6 digits only) that in your reasonable judgment most closelycorresponds to the issuer's primary business activity. | |||
| NAICS industry code | |||
| 212220 | |||
| If the issuer is in thethe mining industry. Select the category that best describes the issuer's stage of operations.ExplorationDevelopmentProduction | mining industry , indicate the stage of operations. This does not apply to issuers that provide services to issuers operating in | ||
| Is the issuer's primary business to invest all or substantially all of its assets in any of the following? If yes, select all that apply.MortgagesReal estate | Commercial/business debtConsumer debt | Private companies | CryptoassetsN/A |
| b) Number of employees | |||
| 0 - 4950 - 99100 - 499500 or more | |||
| c) SEDAR profile number | |||
| Does the issuer have a SEDAR profile ?NoYes | If yes, provide SEDAR profile number:00024879 | If the issuer's SEDAR profile is a "private" profile, please provide ascreenshot of the issuer's profile by e-mail to[email protected] | |
| d) Head office address | If the issuer does not have a SEDAR profile, complete Item 5(d) – (h). | ||
| Street address | Municipality | Province/State | Postal/ZIP code |
| Country | Telephone number | ||
| e) Date of formation and financial year-end | |||
| Date of formation | Financial year-end | ||
| f) Reporting issuer status | |||
| Is the issuer a reporting issuer in any jurisdiction of Canada?NoYes | |||
| If yes, select the jurisdictions of Canada in which the issuer is a reporting issuer.AllABBCMB | NBNLNT | ||
| NSONPENU | QCSKYT | ||
| g) Public listing status | |||
| Does the issuer have a CUSIP number?NoYes | CUSIP number | (provide first 6 digits only) | |
| exchange and not a trading facility such as, for example, an automated trading system. | If the issuer is publicly listed, provide the name of the exchange on which the issuer's equity securities primarily trade. Provide only the name of an | ||
| Exchange name: | |||
| Not ApplicableAequitas Neo Exchange | Toronto Stock ExchangeAustralian Securities Exchange | TSX Venture ExchangeDeutsche Boerse | Canadian Securities ExchangeEuronext |
| London Stock ExchangeNasdaq | New York Stock Exchange | Shanghai Stock Exchange | |
| Shenzhen Stock Exchange | Stock Exchange Of Hong Kong | Tokyo Stock Exchange | OTHER |
| If other, describe: | |||
| h) Size of issuer's assets | |||
| Select the size of the issuer's assets based on its most recently available annual financial statements (Canadian $). If the issuer has not prepared annual | |||
| financial statements for its first financial year, provide the size of the issuer's assets at the distribution end date.$0 to under $5M | $5M to under $25M | $25M to under $100M | |
| $100M to under $500M | $500M to under $1B | $1B or over |
ITEM 7 – INFORMATION ABOUT THE DISTRIBUTION
| If an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include in Item 7 and Schedule 1 information about purchasersresident in that jurisdiction of Canada only. Do not include in Item 7 securities issued as payment of commissions or finder's fees in connection with thedistribution, which must be disclosed in Item 8. The information provided in Item 7 must reconcile with the information provided in Schedule 1 of the report. | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| a) Currency | |||||||||||
| Canadian dollar | US dollar | Euro | Other (describe): | Select the currency or currencies in which the distribution was made. All dollar amounts provided in the report must be in Canadian dollars. | |||||||
| b) Distribution date(s) | |||||||||||
| the distribution period covered by the report. | State the distribution start and end dates. If the report is being filed for securities distributed on only one distribution date, provide the distributiondate as both the start and end dates. If the report is being filed for securities distributed on a continuous basis, include the start and end dates for | ||||||||||
| Start Date2021-01-08 | End Date2021-01-08 | ||||||||||
| c) Detailed purchaser information | |||||||||||
| Attach the completed Excel file here | Complete Schedule 1 of this form for each purchaser and attach the schedule to the completed report. | ||||||||||
| d) Types of securities distributed | |||||||||||
| code. If providing the CUSIP number, indicate the full 9-digit CUSIP number assigned to the security being distributed. | Provide the following information for all distributions reported on a per security basis. Refer to Part A(12) of the Instructions for how to indicate the security | ||||||||||
| Canadian $ | |||||||||||
| Security code | CUSIPnumber | Number ofsecurities | Single or lowestprice | Highest price | Total amount | ||||||
| UBS | 9,346,464.0000 | 7.5000 | 70,098,480.0000 | ||||||||
| Description of security: | Each unit is comprised of one common share and one half of one common share purchaser warrant | ||||||||||
| e) Details of rights and convertible/exchangeable securities | |||||||||||
| If any rights (e.g. warrants, options) were distributed, provide the exercise price and expiry date for each right. If any convertible/exchangeable | |||||||||||
| securities were distributed, provide the conversion ratio and describe any other terms for each convertible/exchangeable security. | |||||||||||
| Not Applicable | |||||||||||
| Convertible / | Underlying | Exercise price | Expiry date | ||||||||
| exchangeablesecurity code | securitycode | (Canadian $)Lowest | Highest | (YYYY-MM-DD) | Conversion ratio | ||||||
| WNT | CMS | 10.0000 | 10.0000 | 2023-12-01 | |||||||
| Describe other terms:Each warrant entitles the holder thereof to acquire one common share during the period commencing on the closing date and | |||||||||||
| (if applicable) | ending on December 1, 2023 | ||||||||||
| f) Summary of the distribution by jurisdiction and exemption | |||||||||||
| State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a | |||||||||||
| distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. | purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a | ||||||||||
| This table requires a separate line item for (i) each jurisdiction where a purchaser resides (ii) each exemption relied on in the jurisdiction where a purchaser | |||||||||||
| For jurisdictions within of Canada, state the province or territory, otherwise state country. | resides, if a purchaser resides in a jurisdiction of Canada, and (iii) each exemption relied on in Canada, if a purchaser resides in a foreign jurisdiction. | ||||||||||
| Province orcountry | Exemption relied on | No. of unique2apurchasers | Total amount(Canadian $) | ||||||||
| Bahamas | NI 45-106 2.10 [Minimum amount investment] | 1 | 262,500.0000 | ||||||||
| Alberta | NI 45-106 2.10 [Minimum amount investment] | 2 | 975,000.0000 | ||||||||
| British Columbia | NI 45-106 2.10 [Minimum amount investment] | 3 | 1,037,497.5000 | ||||||||
| Newfoundland and Labrador | NI 45-106 2.10 [Minimum amount investment] | 1 | 150,000.0000 | ||||||||
| Ontario | NI 45-106 2.10 [Minimum amount investment] | 2 | 675,000.0000 |
| Hong Kong | NI 45-106 2.10 [Minimum amount investment] | $\overline{c}$ | 3,225,000.0000 |
|---|---|---|---|
| United Kingdom | NI 45-106 2.10 [Minimum amount investment] | 1 | 300,000.0000 |
| United States | NI 45-106 2.10 [Minimum amount investment] | $\mathbf 5$ | 2,932,500.0000 |
| Andorra | NI 45-106 2.3 [Accredited investor] | 3 | 104,670.0000 |
| Argentina | NI 45-106 2.3 [Accredited investor] | $\overline{2}$ | 147,000.0000 |
| Australia | NI 45-106 2.3 [Accredited investor] | 41 | 1,864,072.5000 |
| Austria | NI 45-106 2.3 [Accredited investor] | $\overline{2}$ | 30,000.0000 |
| Belgium | NI 45-106 2.3 [Accredited investor] | 3 | 171,300.0000 |
| Bermuda | NI 45-106 2.3 [Accredited investor] | 1 | 375,000.0000 |
| Brazil | NI 45-106 2.3 [Accredited investor] | 3 | 123,750.0000 |
| Bulgaria | NI 45-106 2.3 [Accredited investor] | 1 | 18,750.0000 |
| Alberta | NI 45-106 2.3 [Accredited investor] | 33 | 1,293,982.5000 |
| British Columbia | NI 45-106 2.3 [Accredited investor] | 96 | 5,386,530.0000 |
| Manitoba | NI 45-106 2.3 [Accredited investor] | $\sqrt{2}$ | 13,747.5000 |
| Nova Scotia | NI 45-106 2.3 [Accredited investor] | 1 | 75,000.0000 |
| Ontario | NI 45-106 2.3 [Accredited investor] | 77 | 3,769,672.5000 |
| Prince Edward Island | NI 45-106 2.3 [Accredited investor] | $\overline{2}$ | 99,997.5000 |
| Quebec | NI 45-106 2.3 [Accredited investor] | 23 | 481,650.0000 |
| Saskatchewan | NI 45-106 2.3 [Accredited investor] | $\overline{7}$ | 196,245.0000 |
| Cayman Islands | NI 45-106 2.3 [Accredited investor] | 1 | 56,250.0000 |
| Chile | NI 45-106 2.3 [Accredited investor] | 1 | 75,000.0000 |
| Costa Rica | NI 45-106 2.3 [Accredited investor] | 1 | 375,000.0000 |
| Cyprus | NI 45-106 2.3 [Accredited investor] | 3 | 403,747.5000 |
| Czech Republic | NI 45-106 2.3 [Accredited investor] | $\sqrt{2}$ | 102,225.0000 |
| Denmark | NI 45-106 2.3 [Accredited investor] | 3 | 468,750.0000 |
| Ecuador | NI 45-106 2.3 [Accredited investor] | $\boldsymbol{2}$ | 15,000.0000 |
| Estonia | NI 45-106 2.3 [Accredited investor] | 1 | 3,750.0000 |
| France | NI 45-106 2.3 [Accredited investor] | $\mathbf{1}$ | 7,500.0000 |
| Germany | NI 45-106 2.3 [Accredited investor] | 26 | 1,143,765.0000 |
| Guatemala | NI 45-106 2.3 [Accredited investor] | 1 | 6,517.5000 |
| Hong Kong | NI 45-106 2.3 [Accredited investor] | 12 | 3,621,195.0000 |
| Hungary | NI 45-106 2.3 [Accredited investor] | 1 | 45,000.0000 |
| Ireland | NI 45-106 2.3 [Accredited investor] | $10$ | 681,750.0000 |
| Israel | NI 45-106 2.3 [Accredited investor] | $\sqrt{2}$ | 56,250.0000 |
| Japan | NI 45-106 2.3 [Accredited investor] | $\overline{c}$ | 60,000.0000 |
| Kenya | NI 45-106 2.3 [Accredited investor] | 1 | 22,500.0000 |
| Latvia | NI 45-106 2.3 [Accredited investor] | 1 | 11,250.0000 |
| Liechtenstein | NI 45-106 2.3 [Accredited investor] | $\sqrt{2}$ | 1,162,500.0000 |
| Lithuania | NI 45-106 2.3 [Accredited investor] | 1 | 56,250.0000 |
| Luxembourg | NI 45-106 2.3 [Accredited investor] | 1 | 26,085.0000 |
| Malaysia | NI 45-106 2.3 [Accredited investor] | 3 | 71,250.0000 |
| Malta | NI 45-106 2.3 [Accredited investor] | 2 | 255,000.0000 |
| Mauritius | NI 45-106 2.3 [Accredited investor] | 1 | 18,750.0000 |
| Mexico | NI 45_106 2 3 [Accredited investor] | 51 | 1 011 292 5000 |
| Mexico | NI 45-106 2.3 [Accredited investor] | 5 | 1,011,292.5000 |
|---|---|---|---|
| Monaco | NI 45-106 2.3 [Accredited investor] | 2 | 600,000.0000 |
| Mongolia | NI 45-106 2.3 [Accredited investor] | 1 | 7,500.0000 |
| New Zealand | NI 45-106 2.3 [Accredited investor] | 3 | 67,500.0000 |
| Norway | NI 45-106 2.3 [Accredited investor] | 3 | 202,500.0000 |
| Panama | NI 45-106 2.3 [Accredited investor] | 2 | 30,000.0000 |
| Philippines | NI 45-106 2.3 [Accredited investor] | 2 | 127,170.0000 |
| Poland | NI 45-106 2.3 [Accredited investor] | 4 | 176,250.0000 |
| Portugal | NI 45-106 2.3 [Accredited investor] | 4 | 262,500.0000 |
| Romania | NI 45-106 2.3 [Accredited investor] | 2 | 105,000.0000 |
| Saudi Arabia | NI 45-106 2.3 [Accredited investor] | 4 | 213,750.0000 |
| Seychelles | NI 45-106 2.3 [Accredited investor] | 1 | 30,000.0000 |
| Singapore | NI 45-106 2.3 [Accredited investor] | 17 | 2,666,242.5000 |
| Slovakia | NI 45-106 2.3 [Accredited investor] | 1 | 750,000.0000 |
| South Africa | NI 45-106 2.3 [Accredited investor] | 5 | 263,797.5000 |
| Spain | NI 45-106 2.3 [Accredited investor] | 3 | 161,250.0000 |
| Sweden | NI 45-106 2.3 [Accredited investor] | 5 | 222,060.0000 |
| Switzerland | NI 45-106 2.3 [Accredited investor] | 27 | 3,375,750.0000 |
| Taiwan | NI 45-106 2.3 [Accredited investor] | 2 | 165,000.0000 |
| Thailand | NI 45-106 2.3 [Accredited investor] | 1 | 225,000.0000 |
| United Arab Emirates | NI 45-106 2.3 [Accredited investor] | 5 | 208,035.0000 |
| United Kingdom | NI 45-106 2.3 [Accredited investor] | 1 | 112,500.0000 |
| United States | NI 45-106 2.3 [Accredited investor] | 418 | 23,619,982.5000 |
| Germany | NI 45-106 2.5 [Family, friends and business associates] | 1 | 15,000.0000 |
| Italy | NI 45-106 2.3 [Accredited investor] | 3 | 26,250.0000 |
| Total dollar amount of securities distributed | 70,098,480.0000 | ||
| 2bTotal number of unique purchasers | 919 |
In calculating the number of unique purchasers per row, count each purchaser only once. Joint purchasers may be counted as one purchaser. In calculating the total number of unique purchasers to which the issuer distributed securities, count each purchaser only once, regardless of whether the issuer distributed multiple types of securities to, and relied on multiple exemptions for, that purchaser. 2b 2a
ITEM 7 – INFORMATION ABOUT THE DISTRIBUTION
h) Offering materials - This section applies only in Saskatchewan, Ontario, Québec, New Brunswick and Nova Scotia.
If a distribution has occurred in Saskatchewan, Ontario, Québec, New Brunswick or Nova Scotia, complete the table below by listing the offering materials that are required under the prospectus exemption relied on to be filed with or delivered to the securities regulatory authority or regulator in those jurisdictions.
In Ontario, if the offering materials listed in the table are required to be filed with or delivered to the Ontario Securities Commission (OSC), attach an electronic version of the offering materials that have not been previously filed with or delivered to the OSC.
Not Applicable
| regulator? | ||
|---|---|---|
| YN | ||
ITEM 8 – COMPENSATION INFORMATION
Provide information for each person (as defined in NI 45-106) to whom the issuer directly provides, or will provide, any compensation in connection with the distribution. Complete additional copies of this page if more than one person was, or will be, compensated.
Indicate whether any compensation was paid, or will be paid, in connection with the distribution. No Yes
| PERSON 1 | |||||||
|---|---|---|---|---|---|---|---|
| a) Name of person compensated and registration status | |||||||
| Indicate whether the person compensated is a registrant.NoYes | |||||||
| If the person compensated is an individual, provide the full legal name of the individual. | |||||||
| Family name | First given name | Secondary given names | |||||
| If the person compensated is not an individual, provide the following information.Full legal name of non-individual | Firm NRD number (if applicable) | ||||||
| Indicate whether the person compensated facilitated the distribution through a funding portal or an internet-based portal.NoYes | |||||||
| b) Business contact information | |||||||
| If a firm NRD number is not provided in Item 8(a), provide the business contact information of the person being compensated. | |||||||
| Street address | Municipality | Province/State | Postal/ZIP code | ||||
| Country | Telephone number | Email address | |||||
| c) Relationship to issuer or investment fund manager | |||||||
| Indicate the person's relationship with the issuer or investment fund manager (select all that apply). Refer to the meaning of "connected" inPart B(2) of the Instructions and the meaning of "control" in section 1.4 of NI 45-106 for the purposes of completing this section.Connected with the issuer or investment fund managerEmployee of the issuer or investment fund managerInsider of the issuer (other than an investment fund)None of the aboveDirector or officer of the investment fund or investment fund manager | |||||||
| d) Compensation details | |||||||
| Provide details of all compensation paid, or to be paid, to the person identified in Item 8(a) in connection with the distribution. Provide all amountsin Canadian dollars. Include cash commissions, securities-based compensation, gifts, discounts or other compensation. Do not report paymentsfor services incidental to the distribution, such as clerical, printing, legal or accounting services. An issuer is not required to ask for detailsabout, or report on, internal allocation arrangements with the directors, officers or employees of a non-individual compensated by the issuer. | |||||||
| Cash commissions paid | |||||||
| Value of all securitiesdistributed as | Security code1 | Security code2 | Security code3 | ||||
| 4compensation | Describe terms of warrants, options or other rights | ||||||
| 5Other compensation | Describe | ||||||
| Total compensation Paid | 0.0000 | ||||||
| Check box if the person will or may receive any deferred compensation (describe the terms below) | |||||||
Provide the aggregate value of all securities distributed as compensation, excluding options, warrants or other rights exercisable to acquire additional securities of the issuer. Indicate the security codes for all securities distributed as compensation, including options, warrants or other rights exercisable to acquire additional securities of the issuer. 4
Do not include deferred compensation. 5
| ITEM 9 – DIRECTORS, EXECUTIVE OFFICERS AND PROMOTERS OF THE ISSUER | ||||||
|---|---|---|---|---|---|---|
| Indicate whether the issuer is any of the following (select the one that applies - if more than one applies, select only one). | ||||||
| Reporting issuer in any jurisdiction of Canada | ||||||
| Foreign public issuer | ||||||
| Wholly owned subsidiary of a reporting issuer in any jurisdiction of Canada | 6 | |||||
| Provide name of reporting issuer | ||||||
| 6Wholly owned subsidiary of a foreign public issuer | ||||||
| Provide name of foreign public issuer | ||||||
| Issuer distributing only eligible foreign securities and the distribution is to permitted clients only | 7 | |||||
| If the issuer is at least one of the above, do not complete Item 9(a) – (c). Proceed to Item 10. | ||||||
| 6An issuer is a wholly owned subsidiary of a reporting issuer or a foreign public issuer if all of the issuer's outstanding voting securities, other than | ||||||
| securities that are required by law to be owned by its directors, are beneficially owned by the reporting issuer or the foreign public issuer, respectively.7Check this box if it applies to the current distribution even if the issuer made previous distributions of other types of securities to non-permitted | ||||||
| clients. Refer to the definitions of "eligible foreign security" and "permitted client" in Part B(1) of the Instructions. | ||||||
| If the issuer is none of the above, check this box and complete Item 9(a) – (c). | ||||||
| a) Directors, executive officers and promoters of the issuer | ||||||
| Provide the following information for each director, executive officer and promoter of the issuer. For locations within Canada, state the province or | ||||||
| territory, otherwise state the country. For "Relationship to issuer", "D" – Director, "O" – Executive Officer, "P" – Promoter. | ||||||
| Family name | Business location of | Relationship toissuer | ||||
| Individual?Organization or company name | First given nameSecondary given name | non-individual or residentialjurisdiction of individual | (select all that | |||
| apply) | ||||||
| YN | DOP | |||||
| b) Promoter information | ||||||
| If the promoter listed above is not an individual, provide the following information for each director and executive officer of the promoter. For locationswithin Canada, state the province or territory, otherwise state the country. For "Relationship to promoter", "D" – Director, "O" – Executive Officer. | ||||||
| Family name | Residential jurisdiction | Relationship topromoter | ||||
| Organization or company name | First given nameSecondary given name | of individual | (select one or both | |||
| if applicable) | ||||||
| DO | ||||||
| c) Residential address of each individual | ||||||
| Complete Schedule 2 of this form providing the full residential address for each individual listed in Item 9(a) and (b) andattach to the completed report. Schedule 2 also requires information to be provided about control persons. |
ITEM 10 – CERTIFICATION
| Provide the following certification and business contact information of an officer, director or agent of the issuer or underwriter. If the issuer or |
|---|
| underwriter is not a company, an individual who performs functions similar to that of a director or officer may certify the report. For example, if |
| the issuer is a trust, the report may be certified by the issuer's trustee. If the issuer is an investment fund, a director or officer of the investment |
| fund manager (or, if the investment fund manager is not a company, an individual who performs similar functions) may certify the report if the |
| director or officer has been authorized to do so by the investment fund. |
The certification may be delegated, but only to an agent that has been authorized by an officer or director of the issuer or underwriter to prepare and certify the report on behalf of the issuer or underwriter. If the report is being certified by an agent on behalf of the issuer or underwriter, provide the applicable information for the agent in the boxes below.
If the individual completing and filing the report is different from the individual certifying the report, provide the name and contact details for the individual completing and filing the report in Item 11.
The signature on the report must be in typed form rather than handwritten form. The report may include an electronic signature provided the name of the signatory is also in typed form.
Securities legislation requires an issuer or underwriter that makes a distribution of securities under certain prospectus exemptions to file a completed report of exempt distribution.
By completing the information below, I certify, on behalf of the issuer/underwriter, to the securities regulatory authority or regulator, as applicable, that I have reviewed this report and to my knowledge, having exercised reasonable diligence, the information provided in this report is true and, to the extent required, complete.
| Name of issuer/underwriter/agent | Osisko Development Corp. | ||||
|---|---|---|---|---|---|
| Full legal name - Family name | First given name | Secondary given names | |||
| Brunet | Benoit | ||||
| Title | Telephone number | Email address | |||
| CFO, VP, Finance and Corporate Secretary | 514-940-0685 x 178 | [email protected] | |||
| Signature(s) Benoit Brunet | Date2021-01-18 |
ITEM 11 – CONTACT PERSON
Provide the following business contact information for the individual that the securities regulatory authority or regulator may contact with any questions regarding the contents of this report, if different than the individual certifying the report in Item 10.
Same as individual certifying the report
| Full legal name - Family name | First given name | Secondary given names | Title |
|---|---|---|---|
| Aiello | Claudia | Assistant Corporate Secretary | |
| Name of company | Telephone number | Email address | |
| Osisko Gold Roytalties Ltd | 514-940-0670 | [email protected] |
Notice – Collection and use of personal information
The personal information required under this form is collected on behalf of and used by the securities regulatory authority or regulator under the authority granted in securities legislation for the purposes of the administration and enforcement of the securities legislation.
If you have any questions about the collection and use of this information, contact the securities regulatory authority or regulator in the local jurisdiction(s) where the report is filed, at the address(es) listed at the end of this form.
The attached Schedules 1 and 2 may contain personal information of individuals and details of the distribution(s). The information in Schedules 1 and 2 will not be placed on the public file of any securities regulatory authority or regulator. However, freedom of information legislation may require the securities regulatory authority or regulator to make this information available if requested.
By signing this report, the issuer/underwriter confirms that each individual listed in Schedule 1 or 2 of the report who is resident in a jurisdiction of Canada:
a) has been notified by the issuer/underwriter of the delivery to the securities regulatory authority or regulator of the information pertaining to the individual as set out in Schedule 1 or 2, that this information is being collected by the securities regulatory authority or regulator under the authority granted in securities legislation, that this information is being collected for the purposes of the administration and enforcement of the securities legislation of the local jurisdiction, and of the title, business address and business telephone number of the public official in the local jurisdiction, as set out in this form, who can answer questions about the security regulatory authority's or regulator's indirect collection of the information, and
b) has authorized the indirect collection of the information by the securities regulatory authority or regulator.
| Submission ID | Date |
|---|---|