EX-99.3 4 gdrzfform6kexhibit993051019.htm SUPPLEMENTAL MAILING LIST RETURN CARD gdrzfform6kexhibit993051019.htm - Generated by SEC Publisher for SEC Filing

EXHIBIT 99.3

 


GOLD RESERVE INC.
(the “Corporation”)

Supplemental Mailing List Return Card

Fiscal Year: 2018

Under securities regulations and in accordance with National Instrument 51-102 –Continuous Disclosure Obligations, registered and beneficial securityholders of the Corporation may elect annually to receive a copy of the Corporation’s annual financial statements and corresponding management discussion and analysis (“MD&A”) or interim financial statements and the corresponding MD&A, or both.

If you wish to receive these documents by mail, please return this completed form to:

Computershare Investor Services
P.O. Box 505000
Louisville, KY 40233

Rather than receiving the financial statements and MD&A by mail, you may choose to view these documents on the Corporation’s SEDAR profile at www.sedar.com.

I HEREBY CERTIFY that I am a registered and/or beneficial securityholder of the Corporation, and as such, request that my name be placed on the Corporation’s Mailing List in respect of its annual and/or interim financial statements and the corresponding MD&A for the current financial year.

Please send me:  ¨ Annual Financial Statements and MD&A  
  (Mark this box if you would like to receive the Annual Financial Statements
  and associated MD&A by mail)  
 
 ¨ Interim Financial Statements and MD&A  
  (Mark this box if you would like to receive the Interim Financial Statements
  and associated MD&A by mail)  
PLEASE PRINT    
 
 
FIRST NAME LAST NAME  
 
 
ADDRESS    
 
 
 
 
CITY PROVINCE/ STATE POSTAL / ZIP CODE
COUNTRY    

 

SIGNED: ____________________________
(Signature of Securityholder)

IF THIS IS AN ADDRESS CHANGE, PLEASE CHECK HERE: ¨

(Please provide previous address below)