Attached files
| file | filename |
|---|---|
| EX-99.7 - ALR TECHNOLOGIES INC. | f2salr8k123020ex99_7.htm |
| EX-99.6 - ALR TECHNOLOGIES INC. | f2salr8k123020ex99_6.htm |
| EX-99.5 - ALR TECHNOLOGIES INC. | f2salr8k123020ex99_5.htm |
| EX-99.4 - ALR TECHNOLOGIES INC. | f2salr8k123020ex99_4.htm |
| EX-99.3 - ALR TECHNOLOGIES INC. | f2salr8k123020ex99_3.htm |
| EX-99.2 - ALR TECHNOLOGIES INC. | f2salr8k123020ex99_2.htm |
| EX-99.1 - ALR TECHNOLOGIES INC. | f2salr8k123020ex99_1.htm |
| 8-K - ALR TECHNOLOGIES INC. | f2salr8k123020.htm |
NOMINEE HOLDER CERTIFICATION FORM
The undersigned, a bank, broker, trustee, depositary or other nominee of non-transferable subscription rights (the “Subscription Rights”) to purchase shares of common stock, par value $0.001 per share (the “Common Stock”), of ALR Technologies Inc. (the “Company”) pursuant to the rights offering (the “Rights Offering”) described and provided for in the Company’s Prospectus dated December 4, 2020 (the “Prospectus”), hereby certifies to the Company and to Pacific Stock Transfer Company, as subscription agent for the Rights Offering (the “Subscription Agent”), that (1) the undersigned has exercised, on behalf of the beneficial owners thereof (which may include the undersigned), on the terms and subject to the conditions set forth in the Prospectus, the number of Subscription Rights specified below to purchase the number of shares of Common Stock specified below and, listing separately below each such exercised Subscription Right(s)(without identifying any such beneficial owner by name).
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Number of Rights Held |
Number of Rights Exercised |
Number of Shares Subscribed for Pursuant to Basic Subscription Right |
Number of Shares Subscribed for Pursuant to Over- Subscription Privilege |
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Provide the following information, if applicable:
| Name of Nominee Holder | DTC Participant Number | |||||||
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| DTC Subscription Confirmation Numbers | ||||||||
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