Security Holder Forms


This form is used to transfer the ownership of a security from the registered shareholder to another. In most cases, the new registered owner receives the certificate and the Power of Attorney and presents them to the transfer agent for registration. If the new registered owner is a person, he/she should provide their taxation identification number. The Power of Attorney itself is a legal document that enables a shareholder to designate another person, called the attorney, to act on his/her behalf to register the securities.

When completing the form, it is important to leave the space following “hereby irrevocably constitutes and appoints” blank as Capital Transfer Agency Inc.  is the attorney which will cause the registration. If this part of the panel is completed Capital will require a Release Power of Substitution. Please note that the registration of the security requires the Power of Attorney to be guaranteed by a Schedule I Canadian Chartered Bank or guaranteed by a financial institution that is a member of a recognized Medallion Signature Guarantee Program.

Also, if the security is registered in the name of a company, the Power of Attorney must be accompanied with a Corporate Signing Resolution and a Certificate authorizing the transfer of the security.


 Power of Attorney to transfer Shares

 Corporate Resolution

 Release Power of Substitution


For Clients


 Treasury Directions

 Treasury Directions - TSX-V

 Treasury Cancellation


Estate Transfers


This form is to be used by an Executor or Administrator of the estate to transfer securities

registered in the name of the deceased to the Estate of the Deceased or to a Beneficiary of the

Estate. The Declaration must be sworn before a Judge, Justice of the Peace, Notary or any

person that is permitted to take affidavits to be used in Provincial or Federal courts.


The original certificate must be provided with the completed Declaration and the Certificate must

be endorsed by the executor and guaranteed by a Schedule I Canadian Bank or a financial

institution that is a member of a recognized Medallion Signature Guarantee Program.

The form must be accompanied with an original or notarised Copy of the Letters Probate or a

Probate Bond of Indemnity.


To transfer the securities to the beneficiary, the executor must complete the registration panel

indicating that the securities are to be transferred directly to the beneficiary.


Declaration of Transmission


Annual Meetings

 Proxy Timetable


Cost Basis Reporting for US Companies


All Shareholders and Issuers must fill out the form below when transferring shares.


 Supplemental Cost Basis Worksheet 
    (For both clients and shareholders)