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By Hand or by Courier:
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By Mail:
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100 University Avenue, 8th Floor, North Tower
Toronto, Ontario M5J 2Y1 |
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P.O. Box 7021
31 Adelaide St E Toronto, ON M5C 3H2 Attention: Corporate Actions |
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By Email Transmission:*
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depositoryparticipant@computershare.com
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*(Email transmission is permitted only if all of the following conditions are met: (1) the Loral Common Shares to be exchanged are not represented by certificates; (2) the undersigned is not utilizing the Special Issuance Instructions; and (3) a Medallion Signature Guarantee is not required)
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For Questions:
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Toll Free: 1-800-564-6253
Email: corporateactions@computershare.com |
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ELECTION FORM CHECKLIST
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Step 1 — Complete Election Table, including the forms below if applicable
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Form NR301, Form NR302 or Form NR303 (if you are not Canadian and you made a Telesat Partnership Election with respect to all or any portion of your Deposited Shares).
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Declaration of Canadian residency for purposes of the the Income Tax Act (Canada) (if you are Canadian and you made a Telesat Partnership Election with respect to all or any portion of your Deposited Shares).
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Declaration of Canadian status (“Canadian Status Declaration”) (if you made an election to exchange your Loral Common Shares for Class A Units and/or Class A Shares).
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Step 2 — Signatures
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Provide the requested Stockholder information.
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Guarantor Signature (if applicable).
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Step 3 — If applicable: (a) Complete Special Issuance Instructions (if Telesat Corporation
Shares and/or Telesat Partnership Units are to be issued to an individual or entity that is different from that of the registered holder), or (b) Complete Special Delivery Instructions (if Telesat Corporation Shares and/or Telesat Partnership Units are to be issued to the registered holder at an address different from the registered address) |
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Step 4 — Complete Form W-9 or Form W-8 (as applicable)
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Step 5 — Statement of Lost Certificates (if you hold your Deposited Shares in certificated form
and such certificates have been lost, stolen or destroyed, you will need to complete and sign the Statement of Lost Certificates) |
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As further described herein and in the Proxy Statement/Prospectus (defined below), only Canadian holders may elect to receive Class A Shares and/or Class A Units (see Instruction 12 below).
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ELECTION TABLE
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Deposited Shares
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Election Choices
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Name(s) and Address(es) of Registered Holder(s)(1)
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Certificate Number(s) or Computershare Holder ID(2)
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Number of Loral Common Shares Deposited
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Telesat Partnership Election
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Telesat Corporation Election
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Class A Units(3), (4)
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| | | Class B Units(3) | | | | Class A Shares(4) | | | | Class B Shares | | | |||||||||||||
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| | | LORAL STOCKHOLDERS THAT MAKE A TELESAT PARTNERSHIP ELECTION: | | |
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Holders that are Not Residents of Canada. A holder (other than a holder that is a resident of Canada for the purposes of the Income Tax Act (Canada)) must complete and return with this Election Form Canada Revenue Agency Form NR301 (for use by non-residents other than partnerships or hybrid entities), Form NR302 (for use by partnerships) or Form NR303 (for use by hybrid entities) as applicable (See Instruction 11 below).
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Holders that are Residents of Canada. A holder that is a resident of Canada for the purposes of the Income Tax Act (Canada) must complete the following declaration:
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(name of Holder) declares that (i) it is a resident of Canada for the purposes of the Income Tax Act (Canada), (ii) its social insurance number/business number/trust identification number is: and (iii) it will forthwith advise Telesat Corporation, as general partner of Telesat Partnership, of any change in its residential status.
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| | | ALL LORAL STOCKHOLDERS THAT MAKE A TELESAT PARTNERSHIP ELECTION MUST EITHER PROVIDE CANADA REVENUE AGENCY FORM NR301, NR302 OR NR303 OR COMPLETE THE DECLARATION OF CANADIAN TAX RESIDENCE ABOVE. A LORAL STOCKHOLDER THAT DOES NOT PROVIDE THE APPLICABLE FORM OR DECLARATION WILL BE TREATED AS A NON-RESIDENT OF CANADA THAT IS NOT ENTITLED TO TREATY BENEFITS. | | |
| | | CANADIAN STATUS DECLARATION | | |
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LORAL STOCKHOLDERS THAT ELECT TO EXCHANGE LORAL COMMON SHARES FOR CLASS A UNITS AND/OR CLASS A SHARES:
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Pursuant to the Articles of Telesat Corporation and formation documents of Telesat Partnership, the Class A Units or Class A Shares, as applicable, may only be beneficially owned or controlled, directly or indirectly, by Canadians (as defined in the Investment Canada Act and as set forth below).
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To facilitate compliance with these restrictions when issuing the Class A Units or Class A Shares in consideration for the Deposited Shares pursuant to the Transaction, the undersigned hereby certifies that it has made reasonable inquiries as to the “Canadian” status of the registered holder and the beneficial owner of the Deposited Shares and has read the definitions of “Canadian” set out in Instruction 12 below and hereby declares that the Transaction Consideration will be (check one box based on the definitions set out below):
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owned and controlled by a Canadian
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☐
owned and controlled by a Non-Canadian
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| | | IF YOU DO NOT COMPLETE THIS CANADIAN STATUS DECLARATION OR IF IT IS DETERMINED BY TELESAT CORPORATION, TELESAT PARTNERSHIP OR THEIR TRANSFER AGENT THAT YOU INCORRECTLY INDICATED (THROUGH INADVERTENCE OR OTHERWISE) THAT YOU ARE CANADIAN, YOU WILL BE DEEMED TO BE A PERSON THAT IS A NON-CANADIAN HOLDER AND SHALL RECEIVE CLASS B SHARES OF TELESAT CORPORATION. | | |
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Stockholder Signature/Information
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| | | Dated: , 2021 | | | | | |
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Signature of Stockholder or authorized
representative (see Instructions 2 and 4 below) |
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Name of Stockholder (please print or type)
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Address of Stockholder
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Phone
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Name of authorized representative, if applicable
(please print or type) |
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Guarantor Signature/Information
(if required under Instruction 3 below) |
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Authorized Signature
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Name of Guarantor (please print or type)
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Address of Guarantor
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Special Issuance Instructions
(See Instructions 5 and 9 below) |
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| | | To be completed ONLY if the Transaction Consideration is to be issued to a name that is different from the name or address of the registered holder(s). | | | |||||||||
| | | Issue ☐ Class A Telesat Partnership Units to: | | | |||||||||
| | | Issue ☐ Class B Telesat Partnership Units to: | | | |||||||||
| | | Issue ☐ Class A Telesat Corporation Shares to: | | | |||||||||
| | | Issue ☐ Class B Telesat Corporation Shares to: | | | |||||||||
| | | Name(s): | | |
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| | | Phone: | | |
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Special Delivery Instructions
(See Instruction 6 below) |
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| | | To be completed ONLY if the Transaction Consideration is to be issued to the registered holder(s) at an address that is different from the address reflected above in the section entitled “Step 2. Stockholder and Guarantor Information and Signatures”. | | | |||||||||
| | | Name(s): | | |
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| | | Phone: | | |
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Stockholder Signature/Information
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| | | Dated: , 2021 | | | | | |
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Signature of Stockholder or authorized
representative (see Instructions 2 and 4 below) |
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Name of Stockholder (please print or type)
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Name of authorized representative, if applicable
(please print or type) |
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Guarantor Signature/Information
(if required under Instruction 3 below) |
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Authorized Signature
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Name of Guarantor (please print or type)
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By Hand or by Courier:
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By Mail:
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100 University Avenue, 8th Floor, North Tower
Toronto, Ontario M5J 2Y1 |
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P.O. Box 7021
31 Adelaide St E Toronto, ON M5C 3H2 Attention: Corporate Actions |
|
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By Email Transmission:*
|
|
| |
depositoryparticipant@computershare.com
|
|
| |
*(Email transmission is permitted only if all of the following conditions are met: (1) the Loral Common Shares to be exchanged are not represented by certificates; (2) the undersigned is not utilizing the Special Issuance Instructions; and (3) a Medallion Signature Guarantee is not required)
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For Questions:
|
|
| |
Toll Free: 1-800-564-6253
Email: corporateactions@computershare.com |
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