YOU MUST READ AND SIGN THE DECLARATION. FAILURE TO SIGN THIS FORM MAY RESULT IN A DELAY IN PROCESSING OR THE REJECTION OF YOUR CLAIM.
I acknowledge that I am a Class Member (or the duly authorized representative of a Class Member) bound by and subject to the terms of the Settlement Agreement, Plan of Allocation and any Court order that may form any part of the litigation and settlement. I hereby agree to provide additional information to the Administrator to support this claim, if requested to do so. I have not submitted any other claim covering the same purchases or sales of Xebec’s securities during the Class Period and know of no other person having done so on my behalf.
On behalf of myself and each of my heirs, agents, executors, trustees, administrators, predecessors, successors, and assigns, I submit this Claim Form under the terms of the Settlement Agreement, Plan of Allocation and any Court order that may form any part of the litigation and settlement and enforcing the release and declaration set forth herein.
I hereby warrant and represent that I have not assigned or transferred or purported to assign or transfer, voluntarily or involuntarily, any matter released pursuant to this release or any other part or portion thereof.
I hereby warrant and represent that I have included the information requested about all of my transactions in Xebec’s securities which are the subject of this claim, which occurred during the Class Period, as well as the opening and closing positions in such securities held by me on the dates required in this Claim Form.
Release of Releasees
Pursuant to the Settlement Agreement, Plan of Allocation and Court documents;
Upon the Effective Date, in consideration of payment of the Settlement Amount and for other valuable consideration set forth in the Settlement Agreement, the Releasors forever and absolutely release, waive and discharge the Releasees from the Released Claims that any of them, whether directly, indirectly, or in any other capacity, ever had, now have, or hereafter can, shall or may have.
I declare under penalty of perjury and disqualification to receive payment from the Compensation Fund, under the laws of the Province of Québec, that all of the foregoing information, documentation, calculations and identity supplied in my Claim Form Package by the undersigned is true, accurate and correct.