Till Capital (TIL-CV) 6-K Report of Foreign Private Issuer for the Month of July, 2016

Exhibit 99.4

TILL CAPITAL LTD.		+
	Please return completed form to: Computershare 8th Floor, 100 University Avenue Toronto, Ontario M5J 2Y1

¨		¨
	Interim Financial Statements		Annual Financial Statements
	Mark this box if you would like to		Mark this box if you would like to
	receive Interim Financial		receive the Annual Financial
	Statements by mail.		Statements by mail.

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