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Share Certificate
Number or DRS Holder I.D. |
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Name in which Shares are Registered (please fill in exactly as
name(s) appear(s) on Share Certificate or DRS advice) |
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Number of Shares
Represented by Share Certificate or DRS advice |
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TOTAL:
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BOX A
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ENTITLEMENT DELIVERY
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All Consideration (including TELUS Shares, if any) will be issued and mailed to your existing registration address unless otherwise stated. If you would like your Consideration issued to a different name or address, please complete BOX B and refer to INSTRUCTIONS 2 & 3 below. If the funds payable in cash exceed C$25,000,000, they must be wired to you and you must complete BOX E.
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MAIL CONSIDERATION TO ADDRESS ON RECORD (DEFAULT)
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MAIL CONSIDERATION TO A DIFFERENT ADDRESS (MUST COMPLETE BOX B)
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HOLD CONSIDERATION FOR PICKUP AT THE DEPOSITARY’S OFFICE:
320 Bay Street
14th Floor, Toronto ON M5H 4A6
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DELIVER FUNDS VIA WIRE* (COMPLETE BOX E)
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BOX B
ISSUE CONSIDERATION IN THE NAME OF*
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CHECK BOX IF SAME AS EXISTING REGISTRATION (DEFAULT)
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(NAME)
(STREET NUMBER & NAME)
(CITY AND PROVINCE/STATE)
(COUNTRY AND POSTAL/ZIP CODE)
(TELEPHONE NUMBER (BUSINESS HOURS)
(SOCIAL INSURANCE/SECURITY NUMBER)
*IF THIS NAME IS DIFFERENT FROM YOUR
REGISTRATION, PLEASE PROVIDE SUPPORTING TRANSFER REQUIREMENTS (SEE INSTRUCTION SECTION 2 & 3 |
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BOX C
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RESIDENCY DECLARATION
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ALL SHAREHOLDERS ARE REQUIRED TO COMPLETE A RESIDENCY DECLARATION. FAILURE TO COMPLETE A RESIDENCY DECLARATION MAY RESULT IN A DELAY IN YOUR PAYMENT.
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| | The undersigned represents that: | | |
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The beneficial owner of the Shares deposited herewith is a U.S. Shareholder.
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The beneficial owner of the Shares deposited herewith is not a U.S. Shareholder.
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A “U.S. Shareholder” is any Shareholder who (i) is providing an address in Box B that is located within the United States or any territory or possession thereof, (ii) holds Shares through a “U.S. middleman” within the meaning of Section 1.6049-5(c)(5) of the U.S. Department of the Treasury regulations (generally including, among other things, a U.S. broker), or (iii) is a “U.S. person” for U.S. federal income tax purposes as defined in Instruction 8 below.
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If you are a U.S. person or acting on behalf of a U.S. person, you must provide a completed IRS Form W-9 or otherwise provide certification that you are exempt from backup withholding, as provided in the instructions (see Instruction 8 below). If you are not a U.S. person, but you provide an address that is located within the United States, you must complete an appropriate IRS Form W-8, a copy of which is available from the Depositary upon request. If a completed IRS Form W-9 or IRS Form W-8 is not provided, your payment potentially may be subject to backup withholding of U.S. federal income tax by the Depositary.
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BOX D
TELECOMMUNICATIONS RESIDENCY DECLARATION
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In order for TELUS to determine compliance with applicable Canadian ownership requirements, ALL SHAREHOLDERS ARE REQUIRED TO COMPLETE A TELECOMMUNICATIONS RESIDENCY DECLARATION.
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The undersigned represents that within the meaning of the definitions contained in the Telecommunications Act (Canada) (the “Act”), the Canadian Telecommunications Common Carrier Ownership and Control Regulations (the “Regulations”) and the Articles of TELUS, the beneficial owner of the Shares deposited herewith:
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is Canadian (as defined in Appendix A).
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is a non-Canadian (as defined in Appendix A).
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It is imperative that you complete this Telecommunications Residency Declaration as TELUS may be required to take action relating to the suspension of voting rights and/or other rights in order to ensure that it complies with Canadian ownership requirements. If you do not complete this Telecommunications Residency Declaration, TELUS may take whatever permitted steps it considers appropriate under its Articles, the Act, the Regulations and the agreements that TELUS has with CDS & Co in order to maintain compliance with Canadian ownership requirements.
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You are advised that from and after the effective time of the arrangement, if any TELUS Shares are held for non-Canadians through the CDS Common Canadian ledger ISIN CA87971M1032 (the “Canadian Ledger”), arrangements may be required to remove those non-Canadian TELUS Shares from the Canadian Ledger immediately and have them issued in the Common non-Canadian ISIN CA87971M9969 (the “Non-Canadian Ledger”). The issuance of non-Canadian TELUS Shares requires a valid Reservation Number, which can be requested from Computershare. If Reservation Numbers are available, the shareholder will be able to affect the electronic withdrawal of the non-Canadian TELUS Shares from the Canadian Ledger and subsequent electronic deposit to the Non-Canadian Ledger. If Reservation Numbers are not available because of the non-Canadian ownership level of TELUS, it may still be necessary to have the non-Canadian TELUS Shares withdrawn from the Canadian Ledger and to have Computershare issue a certificate in the Non-Canadian Ledger with a restriction indicating that the certificate was issued without a reservation number and may be non-voting, and these non-Canadian TELUS Shares cannot be dealt with except to sell to a Canadian or until a Reservation Number becomes available.
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If the undersigned is not also the beneficial owner and in control of the Shares deposited herewith, the undersigned must make reasonable inquiries of the beneficial owner(s) or person(s) in control of such Shares to confirm that the statements made in the declaration as they pertain to the beneficial owner or the person in control are true and to obtain their authority to complete this Telecommunications Residency Declaration, if necessary.
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EMAIL ADDRESS:
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TELEPHONE NUMBER:
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**Beneficiary Name(s) that appears on the account at your financial institution — this MUST be the same name and address that your shares are registered to
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| | | | | **Beneficiary Address | | | | | | | | | | | | | | | | **Province/State | | | | | | | |
**Postal Code/Zip Code
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| | | | | **Beneficiary Bank/Financial Institution | | | | | | ||||||||||||||||||||
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| | | | | **Bank Address | | | | | | | | | | | | | | | | **Province/State | | | | | | | |
**Postal Code/Zip Code
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**Bank Account Number
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| | | | | IBAN Number (Europe) | | | | | | | | Sort Code (GBP) | | | | | | | | BSB Number | | | | | | | | BIC Number | | | | | |
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| | | | | Additional Notes and special routing instructions: | | | | | | ||||||||||||||||||||
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BOX F
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CURRENCY ELECTION
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ALL CASH PAYMENTS WILL BE ISSUED IN U.S. DOLLARS UNLESS OTHERWISE ELECTED BELOW.
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| | If you do not check the box below, your payment will be issued in U.S. dollars. | | |
| | ☐ Check here if you wish to have the cash amounts paid in Canadian dollars (C$) | | |
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Cash amounts will be denominated in U.S. dollars. However, a Shareholder can instead elect to receive payment in Canadian dollars, by checking the above, in which case such Shareholder will have acknowledged and agreed that (a) the exchange rate for one U.S. dollar expressed in Canadian dollars will be based on the prevailing market rate(s) available to Computershare Trust Company of Canada, in its capacity as foreign exchange service provider, on the date of the currency conversion, (b) all risks associated with the currency conversion from U.S dollars to Canadian dollars including risks relating to change in rates, the timing of exchange or the selection of a rate for exchange, and all costs incurred with the currency conversion are for the Shareholder’s sole account and will be at such Shareholder’s sole risk and expense, and none of the Company, TELUS or Computershare Trust Company of Canada, or their respective affiliates and successors, are responsible for any such matters and (c) Computershare Trust Company of Canada may earn a commercially reasonable spread between its exchange rate and the rate used by any counterparty from which it purchases the elected currency. Failure to make a currency election by the Election Deadline will result in any cash payment under the arrangement being paid in U.S. dollars.
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BOX G — SIGNATURE GUARANTEE
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BOX H — SIGNATURE
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(if required under Instruction 3)
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Signature guaranteed by:
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Authorized Signature
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Signature of Shareholder or Authorized Representative
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Name of Guarantor (please print or type)
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Signature of any Joint Holder
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Address (please print or type)
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Name of Shareholder
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Area Code and Telephone Number
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Name of Authorized Representative
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Area Code and Daytime Telephone Number
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Email Address
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By Mail
Computershare Investor Services Inc.
P.O. Box 7021 31 Adelaide St. E Toronto, ON, M5C 3H2 Attention: Corporate Actions |
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By Registered Mail, by Hand or by Courier
Computershare Investor Services Inc.
320 Bay Street 14th Floor Toronto, ON, M5H 4A6 Attention: Corporate Actions |
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