| Note: [01 Mar 2017] – The following is a consolidation of 13-501F1. It incorporates amendments to this document that came into effect on March 1, 2017. This consolidation is provided for your convenience and should not be relied on as authoritative. |
| FORM 13-501F1 |
| | CLASS 1 REPORTING ISSUERS AND CLASS 3B REPORTING ISSUERS – |
| PARTICIPATION FEE |
| | | MANAGEMENT CERTIFICATION |
| I, ____________________, 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. | | Kitty Lee |
| | | | | | (s) Kitty Lee |
| _________________________________ | | | | _________________________________ |
| Name: | | | | Date: |
| | |
| Title: |
| Reporting Issuer Name: | | | | | | | | |
| End date of previous financial year: | | | | |
| Type of Reporting Issuer: | [ ] Class 1 reporting issuer | | | | [ ] Class 3B reporting issuer |
| Highest Trading Marketplace: | | | | | | | | |
| Market value of listed or quoted equity securities: |
| Equity Symbol | | | | | |
| 1st Specified Trading Period (dd/mm/yy) | | | | | | _______________ to ______________ | ##!" "" | !!" "" |
| 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 |
| | | | | 60.50 |
| | | | | $ ______________________ (i) |
| 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) | 669,143,714 |
| | (i) x (ii) | $ ______________________ (A) | 40,483,194,697.00 |
| Market value of class or series |
| 2nd Specified Trading Period (dd/mm/yy) | | | _______________ to ______________ | | %# " "" | $ !" "" |
| 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) | | | 60.68 |
| 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) | 636,676,182 |
| | (iii) x (iv) | $ ______________________ (B) | 38,633,510,723.76 |
| Market value of class or series |
| 3rd Specified Trading Period (dd/mm/yy) | | | _______________ to ______________ | | '# " "" | & !" "" |
| 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) | | | 59.81 |
| 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) | 611,515,571 |
| | (v) x (vi) | $ ______________________ (C) | 36,574,746,301.51 |
| Market value of class or series |
| 4th Specified Trading Period (dd/mm/yy) | _______________ to ______________ | | | | ! !" "" | !"#!" "" |
| 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) | 65.95 |
| 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) | 584,152,718 |
| | | (vii) x (viii) $ ______________________ | 38,524,871,752.10 |
| Market value of class or series | | (D) |
| 5th Specified Trading Period (dd/mm/yy) | _______________ to ______________ | | | NA | NA |
| 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) | NA |
| 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) | NA |
| | | (ix) x (x) | $ ______________________ (E) | NA |
| Market value of class or series |
| 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)) |
| | $ ______________________ (1) | 38,554,080,868.59 |
| (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) |
| Certificate Of CompletionEnvelope Id: 997512B5CFB0499399F0D09DB93C9D7E |
| Status: Completed |
| Subject: Complete with DocuSign: IOL - AB Form 13-501F1 (Class 1 and Class 3B)(for completion for FY 202...Source Envelope: Document Pages: 4 |
| | Signatures: 1 | Envelope Originator: |
| Certificate Pages: 2 | | Initials: 0 | Colin Cheng |
| AutoNav: EnabledEnvelopeId Stamping: DisabledTime Zone: (UTC-06:00) Central Time (US & Canada) | Address Redactedcolin.h.cheng@exxonmobil.comIP Address: 136.228.251.50 |
| Record TrackingStatus: Original 1/25/2023 4:28:24 PM |
| | Holder: Colin Cheng colin.h.cheng@exxonmobil.com | Location: DocuSign |
| Security Appliance Status: Connected | | Pool: Main SecApp 1 |
| Signer EventsSignatureTimestamp |
| KITTY LEEkitty.lee@exxonmobil.comTreasurerExxonMobil GeneralSecurity Level: Email, Account Authentication (None) | Sent: 1/25/2023 4:33:19 PMViewed: 1/27/2023 6:49:22 PM Signed: 1/27/2023 6:49:51 PM |
| | Signature Adoption: Uploaded Signature ImageUsing IP Address: 136.228.251.59 |
| Electronic Record and Signature Disclosure: Accepted: 5/18/2022 5:32:41 PM ID: ddb7c3d4-76e1-40a6-a5a1-7cb54c8a5638 Company Name: Exxon Mobil Corporation |
| In Person Signer EventsSignatureTimestamp |
| Editor Delivery EventsStatusTimestamp |
| Agent Delivery EventsStatusTimestamp |
| Intermediary Delivery EventsStatusTimestamp |
| Certified Delivery EventsStatusTimestamp |
| Carbon Copy EventsStatusTimestamp |
| Witness EventsSignatureTimestamp |
| Notary EventsSignatureTimestamp |
| Envelope Summary EventsStatusTimestamps |
| Envelope SentHashed/Encrypted | 1/25/2023 4:33:19 PM |
| Certified DeliveredSecurity Checked | 1/27/2023 6:49:22 PM |
| Signing CompleteSecurity Checked | 1/27/2023 6:49:51 PM |
| CompletedSecurity Checked | 1/27/2023 6:49:51 PM |
| Payment EventsStatusTimestamps |
| Electronic Record and Signature Disclosure |
| | !!" "! ! ! |
| ELECTRONIC RECORD AND SIGNATURE DISCLOSURE ExxonMobil Global Services Company and ExxonMobil Affiliates (“ExxonMobil”) [1] may use the DocuSign service to collect signatures, endorsements, and approvals for corporate purposes. DocuSign may be used by ExxonMobil to conduct corporate business endorsements and approvals or to gather electronic signatures from 3rd parties for business purposes in accordance with local law and contracting guidelines. Please read the information below and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the 'I agree' button. Acknowledging your access and consent to receive materials electronically By checking the 'I agree' box, I confirm that: |
| x | I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and |
| x | I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference. |
| x | I am authorized to do the specific type of work (approve, endorse, etc.) in the country where I am physically located when using DocuSign |
| Getting paper copies You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after signing the document. How to contact Exxon Mobil Corporation: For email address changes or if you have questions about a document you receive please contact the sending ExxonMobil Business organization. [1] ExxonMobil and/or ExxonMobil Affiliates mean (a) Exxon Mobil Corporation or any parent of Exxon Mobil Corporation, (b) any company or partnership in which Exxon Mobil Corporation or any parent of Exxon Mobil Corporation now or hereafter, directly or indirectly (1) owns or (2) controls, more than fifty per cent (50%) of the ownership interest having the right to vote or appoint its directors or functional equivalents ("Affiliated Company") and (c) any joint venture in which Exxon Mobil Corporations, any parent of Exxon Mobil Corporation or an Affiliated Company has day to day operational control. Note, nothing contained herein is intended to override the corporate separateness of affiliated companies. Working relationships discussed in this material do not necessarily represent a reporting connection, but may reflect a functional guidance, stewardship, or service relationship. Where shareholder consideration of a local entity matter is contemplated by this material, responsibility for action remains with the local entity. All actions contemplated herein are subject to observance of corporate separateness principles and other requirements of applicable laws and contractual arrangements. |
| |
