Exhibit 99.4
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| 9th Floor, 100 University Avenue |
| Toronto, Ontario M5J 2Y1 |
| www.computershare.com |
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| Holder Account Number |
Voting Instruction Form ("VIF") - Annual and Special Meeting of Shareholders to be held on May 6, 2008
NON-REGISTERED (BENEFICIAL) SHAREHOLDERS
Notes to proxy
1. | We are sending to you the enclosed proxy-related materials that relate to a meeting of the holders of the series or class of securities that are held on your behalf by the intermediary identified above. Unless you attend the meeting and vote in person, your securities can be voted only by management, as proxy holder of the registered holder, in accordance with your instructions. |
2. | We are prohibited from voting these securities on any of the matters to be acted upon at the meeting without your specific voting instructions. In order for these securities to be voted at the meeting, it will be necessary for us to have your specific voting instructions. Please complete and return the information requested in this VIF to provide your voting instructions to us promptly. |
3. | If you wish to attend the meeting in person or appoint some other person or company, who need not be a shareholder, to attend and act on your behalf at the meeting, please insert your name(s) or the name of your chosen appointee in the space provided (please see reverse). |
4. | This VIF should be signed by you in the exact manner as your name appears on the VIF. If these voting instructions are given on behalf of a body corporate set out the full legal name of the body corporate, the name and position of the person giving voting instructions on behalf of the body corporate and the address for service of the body corporate. |
5. | If this VIF is not dated, it will be deemed to bear the date on which it is mailed by management to you. |
6. | When properly signed and delivered, securities represented by this VIF will be voted as directed by you, however, if such a direction is not made in respect of any matter, the VIF will direct the voting of the securities to be made as recommended in the documentation provided by Management for the meeting. |
7. | This VIF confers discretionary authority on the appointee to vote as the appointee sees fit in respect of amendments or variations to matters identified in the notice of meeting or other matters as may properly come before the meeting or any adjournment thereof. |
8. | Should you wish to receive a legal form of proxy, please write to Computershare at the address indicated above and one will be sent to you by mail. Please remember that a legal proxy is subject to all the terms and conditions that apply to proxies as outlined in the documentation provided by Management including any cut-off time for receipt. |
9. | Your voting instructions will be recorded on receipt of the VIF and a legal form of proxy will be submitted on your behalf. |
10. | By providing voting instructions as requested, you are acknowledging that you are the beneficial owner of, and are entitled to instruct us with respect to the voting of, these securities. |
11. | If you have any questions regarding the enclosed documents, please contact the Registered Representative who services your account. |
12. | This VIF should be read in conjunction with the accompanying documentation provided by Management. |
VIFs submitted must be received by 4:30 pm, Eastern Time, on May 2, 2008.
VOTE USING THE TELEPHONE OR INTERNET 24 HOURS A DAY 7 DAYS A WEEK!
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• | Call the number listed BELOW from a touch tone | | • | Go to the following web site:telephone. www.investorvote.com |
| 1-866-734-VOTE (8683) Toll Free | | | |
If you vote by telephone or the Internet, DO NOT mail back this VIF.
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 choose an appointee other than the Management appointees named on the reverse of this VIF. Instead of mailing this VIF, you may choose one of the two voting methods outlined above to vote this VIF.
To vote by telephone or the Internet, you will need to provide your CONTROL NUMBER, HOLDER ACCOUNT NUMBER and ACCESS NUMBER listed
CONTROL NUMBER | HOLDER ACCOUNT NUMBER | ACCESS NUMBER |
Appointee(s) | | | |
I/We, being holder(s) of Western Goldfields Inc. hereby appoint: Randall Oliphant, or failing this person, Brian Penny, | OR | If you wish to attend in person or appoint someone else to attend on your behalf, print your name or the name of your appointee in this space (see Note #3 on reverse). | |
as my/our proxyholder with full power of substitution and to vote in accordance with the following direction (or if no directions have been given, as the proxyholder sees fit) and all other matters that may properly come before the annual and special meeting of shareholders (the “Meeting”) of Western Goldfields Inc. (the “Company”) to be held at the Le Meridien King Edward Hotel, 37 King Street East, Toronto, Ontario on Tuesday, May 6, 2008 at 4:30 p.m. (Toronto time) and at any adjournment thereof.
VOTING RECOMMENDATIONS ARE INDICATED BY HIGHLIGHTED TEXT OVER THE BOXES.
1. Election of Directors
Management recommends that you vote FOR all of the nominees listed in the Management Information Circular.
| For | Withhold |
Vote FOR or WITHHOLD for all nominees proposed by Management | o | |
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2. Appointment of Auditors | For | Withhold |
To ratify the appointment of PricewaterhouseCoopers LLP, Licensed Public Accountants, as auditors of the Company for the 2007 year and re-appoint them for the ensuing year and to authorize the directors to fix their remuneration; | o | o |
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3. Amendment to Stock Incentive Plan | For | Against |
To consider and, if deemed appropriate, to pass, with or without variation, a resolution amending the Company’s stock incentive plan, as more particularly described in the accompanying management information circular; | o | o |
Authorized Signature(s) - This section must be completed for your instructions to be executed. | | Signature(s) | | Date |
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 VIF with signing capacity stated. | | | | MM / DD / YY |
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Interim Financial Statements | | Annual Report | | | |
Mark this box if you would like to receive interim financial statements and accompanying Management’s Discussion and Analysis by mail. | o | Mark this box if you would like to receive the Annual Report and accompanying Management’s Discussion and Analysis by mail. | o | | Should you wish to receive a legal proxy, refer to Note #8 on reverse |
If you are not mailing back your VIF, you may register online to receive the above financial report(s) by mail at www.computershare.com/mailinglist.