EX-99.3 4 exhibit99-3.htm FORM OF PROXY Exhibit 99.3

Exhibit 99.3


8th Floor, 100 University Avenue
Toronto, Ontario M5J 2Y1
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Security Class 
 
Holder Account Number 
 
 
 





Form of Proxy - Special Meeting to be held on August 9, 2022

This Form of Proxy is solicited by and on behalf of Management.

Notes to proxy
1.

Every holder has the right to appoint some other person or company of their choice, who need not be a holder, to attend and act on their behalf at the meeting or any adjournment or postponement thereof. If you wish to appoint a person or company other than the Management Nominees whose names are printed herein, please insert the name of your chosen proxyholder in the space provided (see reverse).

 

 

2.

If the securities are registered in the name of more than one owner (for example, joint ownership, trustees, executors, etc.), then all those registered should sign this proxy. If you are voting on behalf of a corporation or another individual you may be required to provide documentation evidencing your power to sign this proxy with signing capacity stated.

 

 

3.

This proxy should be signed in the exact manner as the name(s) appear(s) on the proxy.

 

 

4.

If a date is not inserted in the space provided on the reverse of this proxy, it will be deemed to bear the date on which it was mailed to the holder by Management.

 

 

5. 

The securities represented by this proxy will be voted as directed by the holder, however, if such a direction is not made in respect of any matter, and the proxy appoints the Management Nominees listed on the reverse, this proxy will be voted as recommended by Management.

 

 

6.

The securities represented by this proxy will be voted in favour, or withheld from voting, or voted against each of the matters described herein, as applicable, in accordance with the instructions of the holder, on any ballot that may be called for. If you have specified a choice with respect to any matter to be acted on, the securities will be voted accordingly.

 

 

7. 

This proxy confers discretionary authority in respect of amendments or variations to matters identified in the of Meeting and Management Information Circular or other matters that may properly come before the meeting or any adjournment or postponement thereof, unless prohibited by law.

 

 

8.

This proxy should be read in conjunction with the accompanying documentation provided by Management.

Proxies submitted must be received by 8:30 am, PDT, on August 5, 2021

VOTE USING THE TELEPHONE OR INTERNET 24 HOURS A DAY 7 DAYS A WEEK!

     
   To Vote Using the Telephone    To Vote Using the Internet    To Receive Documents Electronically
     
Call the number listed BELOW from a touch tone telephone. Go to the following web site: www.investorvote.com You can enroll to receive future securityholder communications electronically by visiting www. investorcentre.com.
1-866-732-VOTE (8683) Toll Free

Smartphone?
Scan the QR code to vote now.

 

 

 
   
If you vote by telephone or the Internet, DO NOT mail back this proxy.

Voting by mail may be the only method for securities held in the name of a corporation or securities being voted on behalf of another individual.
Voting by mail or by Internet are the only methods by which a holder may appoint a person as proxyholder other than the Management Nominees named on the reverse of this proxy. Instead of mailing this proxy, you may choose one of the two voting methods outlined above to vote this proxy.

To vote by telephone or the Internet, you will need to provide your CONTROL NUMBER listed below.

CONTROL NUMBER





Appointment of Proxyholder    
I/We being holder(s) of securities of Gold Standard Ventures Corp. (the “Company”) hereby appoint: Jason Attew, President and Chief Executive Officer of the Company, or failing this person, Jordan Neeser, Chief Financial Officer and Corporate Secretary of the Company (the “Management Nominees”) OR Print the name of the person you are appointing if this person is someone other than the Management Nominees listed herein.    

as my/our proxyholder with full power of substitution and to attend, act and to vote for and on behalf of the holder in accordance with the following direction (or if no directions have been given, as the proxyholder sees fit) and on all other matters that may properly come before the Special Meeting of shareholders of the Company to be held at Suite 2600 - 595 Burrard Street, Three Bentall Centre, Vancouver, British Columbia V7X 1L3 on August 9, 2022 at 8:30 am, PDT and at any adjournment or postponement thereof.

VOTING RECOMMENDATIONS ARE INDICATED BY HIGHLIGHTED TEXT OVER THE BOXES.



 
          For Against
 
1. Arrangement Resolution     ¨ ¨
To consider and, if deemed advisable, to pass, with or without variation, a special resolution, the full text of which is set forth in Appendix A to the management information circular of the Company dated July 6, 2022, approving a plan of arrangement involving the Company, Orla Mining Ltd. and the securityholders of the Company under Division 5 of Part 9 of the Business Corporations Act (British Columbia).
 


           
Signature of Proxyholder Signature(s) Date
I/We authorize you to act in accordance with my/our instructions set out above. I/We hereby revoke any proxy previously given with respect to the Meeting. If no voting instructions are indicated above, and the proxy appoints the Management Nominees, this Proxy will be voted as recommended by Management.  
  DD / MM / YY  
           

 


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