Subscriber is not an individual)
Name of Subscriber (please print)
Name of authorized signatory (please print)
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EXHIBIT D
US DOLLAR WIRE INSTRUCTIONS
INSTRUCTIONS FOR WIRING FUNDS TO CLARK WILSON LLP
Beneficiary: Clark Wilson LLP, 900 - 885, West Georgia Street, Vancouver BC V6C
3H1
Beneficiary Bank: HSBC Bank Canada, 885 West Georgia Street, Vancouver, BC V6C
3G1, Canada
SWIFT Code: HKBCCATT
Beneficiary Account number: 491689-096
Transit Number: 10020
Bank Code: 016
Correspondent (Intermediary) Bank: Citi Bank, N.A., 111 Wall Street, New York,
NY 10005
Swift Code: CITIUS33
PLEASE ALSO INSTRUCT YOUR BANKER TO QUOTE
YOUR NAME AND OUR FILE NO. 39833-01/CZM
PLEASE ENSURE THAT APPLICABLE WIRE FUNDS FOR YOUR BANK AND $25.00 FOR THE
RECEIVING BANK'S WIRE CHARGES ARE ADDED TO YOUR WIRED SUBSCRIPTION AMOUNT.
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EXHIBIT E
FORM OF DEBENTURE
[see attached]