EX-99.5 6 exhibit99-5.htm EXHIBIT 99.5 Micromem Technologies Inc.: Exhibit 99.5 - Filed by newsfilecorp.com

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

 

I,     Dan Amadori    , an officer of the reporting issuer noted below have examined this Form 13-501F1 (the Form) being submitted hereunder to the Alberta Securities Commission and certify that to my knowledge, having exercised reasonable diligence, the information provided in the Form is complete and accurate. 

 
/s/Dan Amadori, CFO                                                      February 15, 2023                          
Name: Dan Amadori Date:
Title: CFO  
   

Reporting Issuer Name:

                         Micromem Technologies Inc.            

 

 

End date of previous financial year:

                                     October 31, 2023                    

   

Type of Reporting Issuer:

[ X ] Class 1 reporting                                  [    ] Class 3B reporting

 

issuer                                                              issuer

   

Highest Trading Marketplace:

                                          CSE                            


Market value of listed or quoted equity securities:
   
Equity Symbol                       MRM                     
   
1st Specified Trading Period (dd/mm/yy) November 1, 2021  to  January 31, 2022   
   
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
                   $                                   0.075
                   (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
                   $                          443,044,888
                  (ii)
   
Market value of class or series (i) x (ii)      $                            33,228,367
                    (A)

2nd Specified Trading Period (dd/mm/yy) February 1, 2022 to April 30, 2022
   
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                    $ ______________________0.05
marketplace                    (iii)
   
Number of securities in the class or series of such  
security outstanding at the end of the last trading day of                                                       447,191,433
the specified trading period                    (iv)
   
Market value of class or series (iii) x (iv)   $                                   22,359,572
                     (B)
   
3rd Specified Trading Period (dd/mm/yy) May 1, 2022  to  July 31, 2022
   
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                    $ ______________________0.06
marketplace                    (iii)
   
Number of securities in the class or series of such  
security outstanding at the end of the last trading day of                                                      459,085,461
the specified trading period                     (vi)
   
  (v) x (vi)      $                                 27,545,128
Market value of class or series                      (C)


4th Specified Trading Period (dd/mm/yy) August 1, 2022  to  October 31, 2022
   
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                    $                                           0.045
marketplace                    (vii)
   
Number of securities in the class or series of such  
security outstanding at the end of the last trading day of                                                      467,607,678
the specified trading period                     (viii)
   
  (vii) x (viiii) $                                 21,042,346
Market value of class or series                       (D)

5th Specified Trading Period (dd/mm/yy) _______________ to ______________
   
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                     (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                     (x)
   
Market value of class or series (ix) x (x)   $ ______________________
                      (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                     $                               26,043,853
period (i.e. A through E above))                     (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)

$ ______________________

 

(2)

   
Capitalization for the previous financial year (1) + (2)        $                          26,043,853
   
Participation Fee                      $                                     1,200
   
Late Fee, if applicable                      $                                              
   
Total Fee Payable                      $                                     1,200
(Participation Fee plus Late Fee)