INTERNATIONAL TOWER HILL MINES LTD.
(the “Company”)
Request for Annual and/or Interim Financial Statements and related Management’s Discussion and Analysis
National Instrument 51-102 requires the Company to send annually to the registered holders and beneficial owners of its securities (“Securityholders”) a form to allow Securityholders to request a copy of the Company’s annual financial statements and related Management’s Discussion and Analysis (“MD&A”), interim financial statements and related MD&A, or both. If you wish to receive such mailings, please complete and return this form to:
INTERNATIONAL TOWER HILL MINES LTD.
Suite 1920 – 1188 West Georgia Street
Vancouver, BC V6E 4A2
The undersigned Securityholder hereby elects to receive:
¨
Interim Financial Statements for the first quarter ended August 31, 2009, second quarter ended November 30, 2009 and third quarter ended February 29, 2010, and the related MD&A;
¨
Annual Financial Statements for the fiscal year ended May 31, 2010 and related MD&A; or
¨
BOTH – Interim Financial Statements and related MD&A and the Annual Financial Statements and related MD&A.
Please note that a request form will be mailed each year andSecurityholders must return such form each year in order to receive the documents indicated above.
Name:
Address:
Postal Code:
I confirm that I am aregistered/beneficial (circle one) shareholder of the Company.
Signature of
Securityholder:
Date:
CUSIP: 46051L104