Form 31-103F3
USE OF MOBILITY EXEMPTION

(section 2.2 [client mobility exemption – individuals])

This is to notify the securities regulatory authority that the individual named in paragraph 1 is relying on the exemption in section 2.2 [client mobility exemption – individuals] of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

1. Individual information

Name of individual: ___________________________________________________________

NRD number of individual: _______________

The individual is relying on the client mobility exemption in each of the following jurisdictions of Canada:

___________________________________________________________________________

___________________________________________________________________________

2. Firm information

Name of the individual's sponsoring firm: __________________________________________

NRD number of firm: _____________________

Dated: ________________________________________

______________________________________________

(Signature of an authorized signatory of the individual's sponsoring firm)

______________________________________________

(Name and title of authorized signatory)