Exhibit 6
GROWN ROGUE INTERNATIONAL INC.
Request for Financial Statements
Fiscal Year: 2024
In accordance with National Instrument 51-102 – Continuous Disclosure Obligations, registered and beneficial shareholder may elect annually to receive interim (quarterly) financial statements and corresponding management discussion and analysis (“MD&A”) and/or annual financial statements and MD&A.
If you wish to receive these documents by mail or email, please return this completed form to:
CAPITAL TRANSFER AGENCY ULC
390 BAY ST., SUITE 920
TORONTO, ON M5H 2Y2
Rather than receiving financial statements by mail, you may choose to view these documents on the SEDAR website at www.sedar.com.
I HEREBY CERTIFY that I am a registered and/or beneficial holder of the Corporation, and as such, request that my name be placed on the Corporation’s Mailing List in respect to its annual and/or interim financial statements and the corresponding MD&A for the current financial year.
| SHAREHOLDER REGISTRATION (PLEASE PRINT CLEAR IN BLOCK LETTERS) |
|
| STREET ADDRESS |
|
| CITY | PROV/STATE | POSTAL/ZIP CODE |
| | |
| COUNTRY (IF NOT CANADA OR USA) | EMAIL |
| | |
| IF THIS IS AN ADDRESS CHANGE, PLEASE CHECK THE BOX AND PROVIDE YOUR FORMER ADDRESS BELOW |
| ☐ | |
| PLEASE SEND ME THE FOLLOWING: |
| ☐ | Annual Financial Statements with MD&A |
| ☐ | Interim Financial Statements with MD&A |
| SIGNED: | | | DATE: | |
| | (Signature of Shareholder) | | | |
