AI assistant
Prospera Energy Inc. — Capital/Financing Update 2021
May 4, 2021
45573_rns_2021-05-04_59a5dc19-23fd-477e-890e-0c800387ba95.pdf
Capital/Financing Update
Open in viewerOpens in your device viewer
AMENDED Form 45-106F1 Report of Exempt Distribution
ITEM 1 – REPORT T YPE
New report x Amended report If amended, provide filing date of report that is being amended. 2021 03 16 (YYYY-MM-DD)
ITEM 2 – PARTY C ERTIFYING 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.
Investment fund issuer
X Issuer (other than an investment fund) Underwriter
ITEM 3 – I SSUER N AME AND O THER IDENTIFIERS
Provide the following information about the issuer, or if the issuer is an investment fund, about the fund.
Full legal name Prospera Energy Inc. Previous full legal name
If the issuer’s name changed in the last 12 months, provide most recent previous legal name.
Website www.prosperaenergy.com (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
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) (if applicable)
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
Firm NRD number (if applicable) If the underwriter does not have a firm NRD number, provide the head office contact information of the underwriter. Street address Municipality Province/State Country Postal code/Zip code Telephone number Website (if applicable)
1
NATDOCS\54568775\V-1
ITEM 5 – I SSUER INFORMATION
If the issuer is an investment fund, do not complete Item 5. Proceed to Item 6.
a) Primary industry
Provide the issuer’s North American Industry Classification Standard (NAICS) code (6 digits only) that in your reasonable judgment most closely corresponds to the issuer’s primary business activity.
NAICS industry code
2 1 1 1 1 0
If the issuer is in the mining industry , indicate the stage of operations. This does not apply to issuers that provide services to issuers operating in the mining industry. Select the category that best describes the issuer’s stage of operations.
Exploration Development Production
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.
Mortgages Real estate Commercial/business debt Consumer debt Private companies Cryptoassets
b) Number of employees
Number of employees: X 0 – 49 50 – 99 100 – 499 500 or more
c) SEDAR profile number
Does the issuer have a SEDAR profile?
No X Yes If yes, provide SEDAR profile number 0 0 0 2 1 8 2 3
If the issuer does not have a SEDAR profile complete Item 5(d) – (h).
d) Head office address
Street address Province/State Municipality Postal code/Zip code Country Telephone number e) Date of formation and financial year-end Date of formation Financial year-end YYYY MM DD MM DD
f) Reporting issuer status
Is the issuer a reporting issuer in any jurisdiction of Canada? No Yes If yes, select the jurisdictions of Canada in which the issuer is a reporting issuer. All AB BC MB NB NL NT NS NU ON PE QC SK YT g) Public listing status
If the issuer has a CUSIP number, provide below (first 6 digits only).
CUSIP number
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 and not a trading facility such as, for example, an automated trading system.
Exchange name
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
2
NATDOCS\54568775\V-1
$100M to under $500M $500M to under $1B $1B or over
ITEM 6 – INVESTMENT FUND I SSUER INFORMATION
If the issuer is an investment fund, provide the following information.
a) Investment fund manager information Full legal name Firm NRD Number (if applicable)
If the investment fund manager does not have a firm NRD number, provide the head office contact information of the investment fund manager. Street Address Municipality Province/State Country Postal code/Zip code Telephone number Website (if applicable) b) Type of investment fund Type of investment fund that most accurately identifies the issuer (select only one). Money market Equity Fixed income Balanced Alternative strategies Cryptoasset Other (describe) Indicate whether one or both of the following apply to the investment fund. Invests primarily in other investment fund issuers Is a UCITs Fund[1] 1Undertaking for the Collective Investment of Transferable Securities funds (UCITs Funds) are investment funds regulated by the European Union (EU) directives that allow collective investment schemes to operate throughout the EU on a passport basis on authorization from one member state.
c) Date of formation and financial year-end of the investment fund Date of formation Financial year-end YYYY MM DD MM DD d) Reporting issuer status of the investment fund Is the investment fund a reporting issuer in any jurisdiction of Canada? No Yes If yes, select the jurisdictions of Canada in which the investment fund is a reporting issuer. All AB BC MB NB NL NT NS NU ON PE QC SK YT e) Public listing status of the investment fund
If the investment fund has a CUSIP number, provide below (first 6 digits only).
CUSIP number
If the investment fund is publicly listed, provide the name of the exchange on which the investment fund’s securities primarily trade. Provide only the name of an exchange and not a trading facility such as, for example, an automated trading system.
Exchange name
f) Net asset value (NAV) of the investment fund Select the NAV range of the investment fund as of the date of the most recent NAV calculation (Canadian $). $0 to under $5M $5M to under $25M $25M to under $100M $100M to under $500M $500M to under $1B $1B or over Date of NAV calculation: YYYY MM DD
3
NATDOCS\54568775\V-1
ITEM 7 – INFORMATION ABOUT THE D ISTRIBUTION
If an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include in Item 7 and Schedule 1 information about purchasers resident 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 the distribution, 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) Select the currency or currencies in which the distribution was made. All dollar amounts provided in the report must be in Canadian dollars. X Canadian dollar US dollar Euro Other (describe) b) Distribution date(s) State the distribution start and end dates. If the report is being filed for securities distributed on only one distribution date, provide the distribution date 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 the distribution period covered by the report. Start date 2021 03 11 End date 2021 03 11 YYYY MM DD YYYY MM DD c) Detailed purchaser information
State the distribution start and end dates. If the report is being filed for securities distributed on only one distribution date, provide the distribution date 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 the distribution period covered by the report.
Complete Schedule 1 of this form for each purchaser and attach the schedule to the completed report.
d) Types of securities 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 code. If providing the CUSIP number, indicate the full 9-digit CUSIP number assigned to the security being distributed.
| Canadian $ | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Security code |
CUSIP number (if applicable) |
Description of security | Number of securities Single or lowest price Highest price Total amount |
||||||||||||||||
| Issuance of units at a price of $0.02 per unit. | |||||||||||||||||||
| U | B | S | Each unit is comprised of one common share | 29,798,335 0.02 0.02 595,966.74 |
|||||||||||||||
| and one commonshare | purchasewarrant. | ||||||||||||||||||
| 8% Unsecured Convertible debentures, | |||||||||||||||||||
| convertible into units at $0.05 per unit in year | |||||||||||||||||||
| C | V | D | one, and $0.10 in year two. Each unit consists of 1 common share and 1 warrant. Principal plus |
382,776.67 1.00 1.00 382,776.67 |
|||||||||||||||
| any unpaid interest may be paid in cash or | |||||||||||||||||||
| shares. | |||||||||||||||||||
| 978,743.41 | |||||||||||||||||||
| e) | Details | of rights and convertible/exchangeable securities | |||||||||||||||||
| If | any rights (e.g. warrants, options) | were distributed, provide the exercise price and | expiry date for each right. If any convertible/exchangeable | ||||||||||||||||
| securities were | distributed, provide the conversion ratio and describe any other terms for each convertible/exchangeable security. | ||||||||||||||||||
| Convertible / exchangeable security code |
Underlying security code |
Exercise price (Canadian$) Lowest Highest |
Expiry date (YYYY-MM-DD) |
Conversion ratio Describe other terms (if applicable) |
|||||||||||||||
| Each warrant entitles the holder to | |||||||||||||||||||
| subscribe for one additional share at $0.05 | |||||||||||||||||||
| per share for a period of 2 years, subject to | |||||||||||||||||||
| W | N | T | C | M | S | 0.05 0.05 |
2023-03-11 | 1:1 the Corporation’s option to accelerate the expiry of warrants to 15 days, in the event |
|||||||||||
| that the shares trade at $0.10 for five | |||||||||||||||||||
| consecurive days following the expiry of the | |||||||||||||||||||
| 4 month hold period. | |||||||||||||||||||
| Each warrant entitles the holder to acquire | |||||||||||||||||||
| one comon share at $0.075 for a period of | |||||||||||||||||||
| two years,subject to the Corporation’s | |||||||||||||||||||
| C | V | D | U | B | S | 0.075 0.075 |
2023-03-11 | 1:1 option to accelerate the expiry of warrants to 15 days, in the event that the shares |
|||||||||||
| trade at $0.10 for five consecurive days | |||||||||||||||||||
| following the expiry of the 4 month hold | |||||||||||||||||||
| period. | |||||||||||||||||||
| f) | Summary of the distribution by jurisdiction and exemption |
4
NATDOCS\54568775\V-1
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only.
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 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.
For jurisdictions within Canada, state the province or territory, otherwise state the country.
| State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
State the total dollar amount of securities distributed and the number of purchasers for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides and for each exemption relied on in Canada for that distribution. However, if an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include distributions to purchasers resident in that jurisdiction of Canada only. 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 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. Forjurisdictions within Canada, state theprovince or territory, otherwise state the country. |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Province or country | Exemption relied on | Number of unique purchasers2a |
Total amount (Canadian $) | ||||||||
| Alberta | NI 45-106 2.3[Accredited Investor] | 4 | 380,400.08 | ||||||||
| Alberta | NI 45-106 2.5 [Family, friends and business associates] |
6 | 410,010 | ||||||||
| British Columbia |
NI 45-106 2.3 [Accredited Investor] | 2 | 153,333.33 | ||||||||
| British Columbia |
NI 45-106 2.5 [Family, friends and business associates] |
2 | 35,000 | ||||||||
| Total dollar amount of securities distributed | 978,743.41 | ||||||||||
| Total number of uniquepurchasers2b | 14 | ||||||||||
| 2aIn calculating the number of unique purchasers per row, count each purchaser only once. Joint purchasers may be counted as one purchaser. 2bIn 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. |
|||||||||||
| g) Netproceeds to the investment fund by jurisdiction |
|||||||||||
| If the issuer is an investment fund, provide the net proceeds to the investment fund for each jurisdiction of Canada and foreign jurisdiction where a purchaser resides.3 If an issuer located outside of Canada completes a distribution in a jurisdiction of Canada, include net proceeds for that jurisdiction of Canada only. For jurisdictions within Canada, state the province or territory, otherwise state the country. Province or country Net proceeds (Canadian $) Total net proceeds to the investment fund |
|||||||||||
| Province or country | Net proceeds (Canadian $) |
||||||||||
| Total net proceeds to the investment fund | |||||||||||
| 3“Net proceeds” | |||||||||||
| h) Offeringmaterials –This section applies onlyinSaskatchewan,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. |
|||||||||||
| Description | Date of document or other material (YYYY-MM-DD) |
Previously filed with or delivered to regulator? (Y/N) |
Date previously filed or delivered (YYYY-MM-DD) |
||||||||
| 1. | |||||||||||
| 2. | |||||||||||
| 3. | |||||||||||
| Description | Date of document or other material (YYYY-MM-DD) |
Previously filed with or delivered to regulator? (Y/N) |
Date previously filed or delivered (YYYY-MM-DD) |
||
|---|---|---|---|---|---|
| 1. | |||||
| 2. | |||||
| 3. | |||||
5
NATDOCS\54568775\V-1
ITEM 8 – C OMPENSATION INFORMATION
| ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION | ITEM8 – COMPENSATIONINFORMATION |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 thispage if more than oneperson was, or will be, compensated. |
||||||||||
| Indicate whether any compensation was paid, or will be paid, in connection with the distribution. No X Yes If yes, indicate number of persons compensated. 1 |
||||||||||
| a) Name ofperson compensated and registration status |
||||||||||
| Indicate whether theperson compensated is a registrant. X No Yes If the person compensated is an individual,provide the name of the individual. Full legal name of individual Nanos Dustin 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 theperson compensated facilitated the distribution through a funding portal or an internet-based portal. |
||||||||||
| X | No | Yes | ||||||||
| b) Business contact information |
||||||||||
| If a firm NRD number is not provided in Item 8(a), provide the business contact information of theperson being compensated. Street address 60 Signal Hill WaySW Municipality Calgary Province/State Alberta |
||||||||||
| 60 Signal Hill WaySW | ||||||||||
| Calgary Province/State |
||||||||||
| Country | Canada | Postal code/Zip code | T3H 2M2 | |||||||
| Email address | [email protected] Telephone number |
587-577-9878 | ||||||||
| c) Relationshipto 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” in Part 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 manager |
||||||||||
| Insider of the issuer (other than an investment fund) | ||||||||||
| Director or officer of the investment fund or investment fund manager | ||||||||||
| Employee of the issuer or investment fund manager | ||||||||||
| X | None of the above | |||||||||
| 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 amounts in Canadian dollars. Include cash commissions, securities-based compensation, gifts, discounts or other compensation. Do not report payments for services incidental to the distribution, such as clerical, printing, legal or accounting services. An issuer is not required to ask for details about, or report on, internal allocation arrangements with the directors, officers or employees of a non-individual compensated by the issuer. |
||||||||||
| Cash commissions paid | $200 |
|||||||||
| Value of all securities distributed as compensation4 0 Security codes Securitycode 1 Securitycode 2 Securitycode 3 W N T Describe terms of warrants, options or other rights Issuance of 55,720 finder’s warrants. Each finder’s warrant is exercisable to purchase one additional common share of the Issuer at a price of $0.05 per share for a period of two years. Expiry date of finders’warrant is March 11, 2023 Other compensation5 0 Describe Total compensation paid $200 Check box if theperson will or mayreceive anydeferred compensation (describe the terms below) |
==> picture [475 x 128] intentionally omitted <==
----- Start of picture text -----
Cash commissions paid $200
Value of all securities Security code 1 Security code 2 Security code 3
distributed as 0 Security codes
W N T
compensation [4]
Issuance of 55,720 finder’s warrants. Each finder’s warrant
is exercisable to purchase one additional common share of
Describe terms of warrants, options or other rights
the Issuer at a price of $0.05 per share for a period of two
years. Expiry date of finders’ warrant is March 11, 2023
Other compensation [5] 0 Describe
Total compensation paid $200
----- End of picture text -----
Check box if the person will or may receive any deferred compensation (describe the terms below)
6
NATDOCS\54568775\V-1
4Provide 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.
5Do not include deferred compensation.
ITEM 9 – DIRECTORS, EXECUTIVE OFFICERS AND PROMOTERS OF THE ISSUER
If the issuer is an investment fund, do not complete Item 9. Proceed to Item 10.
Indicate whether the issuer is any of the following (select the one that applies – if more than one applies, select only one). X 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 Wholly owned subsidiary of a foreign public issuer[6] 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).
==> picture [521 x 219] intentionally omitted <==
----- Start of picture text -----
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.
Business location of
Relationship to
non-individual or
issuer
residential
First given Secondary given (select all that
Organization or company name Family name name names jurisdiction of individual apply)
Province or country D O P
b) Promoter information
----- End of picture text -----
If the promoter listed above is not an individual, provide the following information for each director and executive officer of the promoter. For locations within Canada, state the province or territory, otherwise state the country. For “Relationship to promoter”, “D” – Director, “O” – Executive Officer.
| Organization or company name | Fi i | Residential idii f |
Relationship to promoter (select one or both if applicable) |
Relationship to promoter (select one or both if applicable) |
||
|---|---|---|---|---|---|---|
| Secondary | jurscton o idiidl |
|||||
| Family name | rst gven name |
i |
||||
| gven |
nvua |
|||||
| names | Province or country |
D | O | |||
7
NATDOCS\54568775\V-1
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) and attach 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/investment fund manager, 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/ investment fund Prospera Energy Inc. manager/agent Full legal name Davarej Samuel David Family name First given name Secondary given names Title Director Telephone number 403-454-9010 Email address [email protected] Signature (signed) “Sam Davarej” Date 2021 05 04 YYYY MM DD
ITEM 11 – CONTACT P ERSON
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.
| uestions regarding the contents of this report, if different than the individual certifying the report in Item 10. | uestions regarding the contents of this report, if different than the individual certifying the report in Item 10. | uestions regarding the contents of this report, if different than the individual certifying the report in Item 10. | |
|---|---|---|---|
| X Same as individual certifying the report Full legal name Title Family name First given name Secondary given names Name of company Telephone number Email address |
|||
| Email address | |||
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
8
NATDOCS\54568775\V-1
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.
9
NATDOCS\54568775\V-1