EX-99.4 5 denison-2018albertapartic.htm ALBERTA REPORTING ISSUER PARTICIPATION FEE FORM Blueprint
 
Note: [01 Mar 2017] – The following is a consolidation of 13-501F1. It incorporates amendments to this document that came into effect on March 1, 2017. This consolidation is provided for your convenience and should not be relied on as authoritative.
 
FORM 13-501F1
CLASS 1 REPORTING ISSUERS AND CLASS 3B REPORTING ISSUERS – PARTICIPATION FEE
 
MANAGEMENT CERTIFICATION
 
 
 
 
Reporting Issuer Name:
 
            
Denison Mines Corp. 
End date of previous financial year:
 
            
December 31, 2018                
 
Type of Reporting Issuer:                                                                        [ X ] Class 1 reporting issuer
 
[       
] Class 3B reporting issuer
Highest Trading Marketplace:
 
          
Toronto Stock Exchange        
 
Market value of listed or quoted equity securities:
 
Equity Symbol
 
 
                 
DML                       
 
1st Specified Trading Period (dd/mm/yy)
 
         
01/01/18                                                
to 31/03/18
 
  Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace
 
$                                    
0.5800 (i)
 
 
 
Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period
 
                             
559,183,209
(ii)
 
 
Market value of class or series
 
(i) x (ii)                                             
$           
324,326,261.22
(A)
 
 
 
2nd Specified Trading Period (dd/mm/yy)
 
         
01/04/18                                                
to 30/06/18
 
Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace
 
 
 
$                                    
0.6400 (iii)
 
Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period
 
 
                           
559,183,209
(iv)
 
 
Market value of class or series
 
(iii) x (iv)                                             
$           
357,877,253.76
(B)
 
 
 
3rd Specified Trading Period (dd/mm/yy)
 
         
01/07/18                                                  
to 30/09/18
 
Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace
 
 
 
$                                    
0.8500 (v)
 
Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period
 
 
                          
559,183,209
(vi)
 
 
 
Market value of class or series
 
(v) x (vi)                      
$                         
475,305,727.65
(C)
 
 

4th Specified Trading Period (dd/mm/yy)
 
         
01/10/18                                                
to 31/12/18
  
Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace
 
 
$                                    
0.6300 (vii)
 
Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period
 
 
                           
589,175,086
(viii)
 
 
Market value of class or series
 
(vii) x (viii)                                             
$           
371,180,304.18
(D)
 
 
 
5th Specified Trading Period (dd/mm/yy)
 
         
01/01/18  
to     31/12/18
 
Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace
 
 
 
$                                    
0.6300 (ix)
 
Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period
 
 
                           
589,175,086
(x)
 
 
Market value of class or series
 
(ix) x (x)                                             
$           
371,180,304.18
(E)
 
 
 
Average Market Value of Class or Series (Calculate the simple average of the market value of the class or series of security for each applicable specified trading period (i.e. A through E above))
 
 
 
$                           
379,973,970.20
 
(1)
 
 
(Repeat the above calculation for each other class or series of equity securities of the reporting issuer (and a subsidiary, if applicable) that was listed or quoted on a marketplace at the end of the previous financial year)
 
 
 
Fair value of outstanding debt securities:
 
(Provide details of how value was determined)
 
 
 
$                                    0.0000
 
 
(2)
 
Capitalization for the previous financial year
 
(1) + (2)
 
$                           379,973,970.20
 
Participation Fee
 
 
$                             14,000.0000
 
Late Fee, if applicable
 
 
$                                            
 
Total Fee Payable
 
 
$                             14,000.0000
(Participation Fee plus Late Fee)