Exhibit 99.4
FORM 13-501F1
CLASS 1 REPORTING ISSUERS AND CLASS 3B REPORTING ISSUERS
PARTICIPATION FEE
MANAGEMENT CERTIFICATION
I, Mark Vendetti, an officer of the reporting issuer noted below have examined this Form 13-501F1 (the Form) being submitted hereunder to the Alberta Securities Commission and certify that to my knowledge, having exercised reasonable diligence, the information provided in the Form is complete and accurate.
/s/ “Mark Vendetti” | | March 31, 2023 |
Mark Vendetti | | Date |
Chief Financial Officer | | |
Reporting Issuer Name: | Glass House Brands Inc. |
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End date of previous financial year: | December 31, 2022 |
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Type of Reporting Issuer: | Class 1 reporting issuer |
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Highest Trading Marketplace: | NEO Exchange |
Market value of listed or quoted equity securities: | | |
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Equity Symbol | | GLAS.A.U and GLAS.WT.U | |
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1st Specified Trading Period (dd/mm/yy) | | Please see attached Schedule “A” | |
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Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace | | | (i) |
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Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period | | | (ii) |
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Market value of class or series | (i) x (ii) | | (A) |
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2nd Specified Trading Period (dd/mm/yy) | | Please see attached Schedule “A” | |
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Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace | | | (iii) |
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Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period | | | (iv) |
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Market value of class or series | (iii) x (iv) | | (B) |
3rd Specified Trading Period (dd/mm/yy) | | Please see attached Schedule “A” | |
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Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace | | | (v) |
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Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period | | | (vi) |
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Market value of class or series | (v) x (vi) | | (C) |
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4th Specified Trading Period (dd/mm/yy) | | Please see attached Schedule “A” | |
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Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace | | | (vii) |
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Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period | | | (viii) |
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Market value of class or series | (vii) x (viii) | | (D) |
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5th Specified Trading Period (dd/mm/yy) | | N/A | |
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Closing price of the security in the class or series on the last trading day of the specified trading period in which such security was listed or quoted on the highest trading marketplace | | $ | (ix) |
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Number of securities in the class or series of such security outstanding at the end of the last trading day of the specified trading period | | | (x) |
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Market value of class or series | (ix) x (x) | $ | (E) |
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Average Market Value of Class or Series (Calculate the simple average of the market value of the class or series of security for each applicable specified trading period (i.e. A through E above)) | Shares: | $ 158,093,641.35 | (1) |
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| Warrants: | $ 19,873,300.00 | (2) |
(Repeat the above calculation for each other class or series of equity securities of the reporting issuer (and a subsidiary, if applicable) that was listed or quoted on a marketplace at the end of the previous financial year)
Fair value of outstanding debt securities: | | $ 20,504,850.96 | (3) |
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(Provide details of how value was determined) | | | |
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Capitalization for the previous financial year | (1) + (2) + (3) | $ 198,471,792.31 | |
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Participation Fee | | $ 6,500.00 | |
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Late Fee, if applicable | | $ - | |
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Total Fee Payable | | | |
(Participation Fee plus Late Fee) | | $ 6,500.00 | |
SCHEDULE “A”
GLASS HOUSE BRANDS INC.
Capitalization Calculation
Fiscal Year Ended December 2022
SUBORDINATE VOTING EQUITY SHARES (GLAS.A.U) | | | | | |
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| | Quarter | | Number of shares | | Closing Price | | Market Value | |
Q1 | | 31-Mar-2022 | | 56,253,908 | | 5.010 | | 281,832,079.08 | |
Q2 | | 30-Jun-2022 | | 44,797,350 | | 2.770 | | 124,088,659.50 | |
Q3 | | 30-Sep-2022 | | 52,718,713 | | 2.250 | | 118,617,104.25 | |
Q4 | | 31-Dec-2022 | | 55,018,736 | | 1.960 | | 107,836,722.56 | |
Average Market Value: | | | | | | 158,093,641.35 | |
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WARRANTS (GLAS.WT.U) | | | | | |
| | Quarter | | Number of warrants | | Closing Price | | Market Value | |
Q1 | | 31-Mar-2022 | | 30,489,500 | | 1.340 | | 40,855,930.00 | |
Q2 | | 30-Jun-2022 | | 30,664,500 | | 0.590 | | 18,092,055.00 | |
Q3 | | 30-Sep-2022 | | 30,664,500 | | 0.245 | | 7,512,802.50 | |
Q4 | | 31-Dec-2022 | | 30,664,500 | | 0.425 | | 13,032,412.50 | |
Average Market Value: | | | | | | 19,873,300.00 | |
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Fair Value of Outstanding Debt Securities: | | | | 20,504,850.96 | |
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Capitalization for the financial year: | | | | 198,471,792.31 | |