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DEBENTURE HOLDERS INSTRUMENT CANCELLATION



This Debenture holders Instrument Cancellation (the Agreement) is effective [DATE],


BETWEEN:  [YOUR COMPANY NAME] (the "Debenture Holder), a company organized and existing under the laws of the [State/Province] of [STATE/PROVINCE], with its head office located at:

      [YOUR COMPLETE ADDRESS]


AND:  [COMPANY NAME] (the "Trustee"), a company organized and existing under the laws of the [State/Province] of [STATE/PROVINCE], with its head office located at:

  [COMPLETE ADDRESS]


We are the sole debenture holder under the Trust Deed of Hypothec, Mortgage and Pledge executed by the Company in favor of [YOUR COMPANY NAME] before Notary [INDIVIDUAL NAME] under his minute number [NUMBER], which was registered at the Registry Office for the Registration Division of [STATE/PROVINCE] on [DATE], under the number [NUMBER] and at the Registry Office for the Registration Division of [STATE/PROVINCE] on [DATE] under the number [NUMBER] (the Trust Deed).

We hereby authorize and instruct you, in your capacity as Trustee under the Trust Deed, to do the following:

cancel the attached duly executed and certified original debenture of the Company registered in our name and created and issued under the Trust Deed;

strike our name from the register kept by yourselves under the Trust Deed; and

sign, execute and deliver the Deed of Acquaintance and Discharge, dated as of [DATE], attached as a schedule hereto.

And for so doing, let this be your good, sufficient and irrevocable authority.


IN WITNESS WHEREOF, each party to this agreement has caused it to be executed at [PLACE OF EXECUTION] on the date indicated above.


COMPANY             TRUSTEE


                          
Authorized Signature          Authorized Signature


                          
Print Name and Title          Print Name and Title

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