Auxly Cannabis Group Inc. Settlement Claim Form • Berger Montague (Canada) PC

Only shares purchased during the identified Class Period and held until after February 6, 2019, will be considered to be included within the Settlement.

Class Period: ONLY SHARES PURCHASED BETWEEN NOVEMBER 12, 2018 THROUGH FEBRUARY 6, 2019

You must complete the form below before April 13, 2024, so you can register to receive a distribution of the Settlement Funds.

Full Name*

Email*

Phone number

Street Address

Address Line 2

City

Province / State

Zip / Postal Code

Country

Securities Purchase / Sell Dates

Please list each purchase date and sell date

Purchased Date {{rep-purchases_index}}

Sell Date {{rep-sales_index}}

Number of Securities owned after February 6, 2019

You must provide the following Supporting Documents to be eligible.

Government issued identification that matches your brokerage account statements
Your November and December 2018 Brokerage Statements
Your January and February 2019 Brokerage Statements
Your February 2019 Brokerage Statement is required

Government issued identification

Images and PDF files accepted. Max 10 MB

Brokerage Statements

Upload as many brokerage statements as possible to support your claim. PDF formatting is required.

Brokerage Statement {{rep-statements_index}}

PDF only. Max 10 MB each

If you are having any difficulties or have questions please contact us.

Whether or not if you qualify for a pro rata share of the Settlement Funds you will be contacted after the Claims Bar Deadline as to whether the amount can be e-transferred or sent by check.

Class or Class Members means a natural or legal person meets the following criteria:

Class Members:

All persons and entities, other than Excluded Persons, wherever they may reside or be domiciled, who acquired Auxly’s securities between November 12, 2018 and February 6, 2019, and held some or all of those securities after February 6, 2019.

Excluded Persons: means the defendants and the individual defendants’ immediate family members, and persons or entities that properly opt-out of the class in accordance with the certification order issued by the court.