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Viscount Mining Corp. — Regulatory Filings 2021
Dec 24, 2021
47016_rns_2021-12-24_72e4601c-ac28-4476-83ca-11e9afdc8445.pdf
Regulatory Filings
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FORM 13-501F1 CLASS 1 REPORTING ISSUERS AND CLASS 3B REPORTING ISSUERS – PARTICIPATION FEE
MANAGEMENT CERTIFICATION
| I,____________________, an officer of the reporting issuer noted below have examined thisForm 13-501F1 (the Form) being submitted hereunder to the Alberta Securities Commission andcertify that to my knowledge, having exercised reasonable diligence, the information provided inthe Form is complete and accurate. | |||||
|---|---|---|---|---|---|
| _________________________________ | _________________________________ | ||||
| Name:Title: | Date: | ||||
| Reporting Issuer Name: | |||||
| End date of previous financial year: | |||||
| Type of Reporting Issuer: | [] Class 1 reportingissuer | [ | issuer | ] Class 3B reporting | |
| Highest Trading Marketplace: | |||||
| Market value of listed or quoted equity securities:Equity Symbol | |||||
| 1st Specified Trading Period(dd/mm/yy) | _______________ to ______________ | ||||
| Closing price of the security in the class or series on thelast trading day of the specified trading period in whichsuch security was listed or quoted on the highest tradingmarketplace | (i) | $ ______________________ |
| Number of securities in the class or series of suchsecurity outstanding at the end of the last trading day of | ________________________ | ||
|---|---|---|---|
| the specified trading period | (ii) | ||
| Market value of class or series | (i) x (ii) | (A) | $ ______________________ |
| 2nd Specified Trading Period(dd/mm/yy) | _______________ to ______________ | ||
| Closing price of the security in the class or series on thelast trading day of the specified trading period in whichsuch security was listed or quoted on the highest tradingmarketplace | (iii) | $ ______________________ | |
| Number of securities in the class or series of suchsecurity outstanding at the end of the last trading day ofthe specified trading period | (iv) | ______________________ | |
| Market value of class or series | (iii) x (iv) | (B) | $ ______________________ |
| 3rd Specified Trading Period(dd/mm/yy) | _______________ to ______________ | ||
| Closing price of the security in the class or series on thelast trading day of the specified trading period in whichsuch security was listed or quoted on the highest tradingmarketplace | (v) | $ ______________________ | |
| Number of securities in the class or series of suchsecurity outstanding at the end of the last trading day ofthe specified trading period | (vi) | ______________________ | |
| Market value of class or series | (v) x (vi) | (C) | $ ______________________ |
| 4th Specified Trading Period(dd/mm/yy) | _______________ to ______________ | ||
|---|---|---|---|
| Closing price of the security in the class or series on thelast trading day of the specified trading period in whichsuch security was listed or quoted on the highest tradingmarketplace | (vii) | $ ______________________ | |
| Number of securities in the class or series of suchsecurity outstanding at the end of the last trading day ofthe specified trading period | (viii) | ______________________ | |
| Market value of class or series | (vii) x (viii) | (D) | $ ______________________ |
| 5th Specified Trading Period(dd/mm/yy) | _______________ to ______________ | ||
| Closing price of the security in the class or series on thelast trading day of the specified trading period in whichsuch security was listed or quoted on the highest tradingmarketplace | (ix) | $ ______________________ | |
| Number of securities in the class or series ofsuchsecurity outstanding at the end of the last trading day ofthe specified trading period | (x) | ______________________ | |
| Market value of class or series | (ix) x (x) | (E) | $ ______________________ |
| Average Market Value of Class or Series(Calculatethe simple average of the market value of the class orseries of security for each applicable specified tradingperiod (i.e. A through E above)) | (1) | $ ______________________ |
(Repeat the above calculation for each other class or series of equity securities of the reporting issuer (and a subsidiary, if applicable) that was listed or quoted on a marketplace at the end of the previous financial year)
Fair value of outstanding debt securities:
| (Provide details of how value was determined) | (2) | $ ______________________ | |
|---|---|---|---|
| Capitalization for the previous financial year | (1) + (2) | $ ______________________ | |
| Participation Fee | $ ______________________ | ||
| Late Fee, if applicable | $ ______________________ | ||
| Total Fee Payable(Participation Fee plus Late Fee) | $ ______________________ |
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