Exhibit 99.4
Sphere 3D Corp.
Request for Financial Statements
2021
In accordance with National Instrument 51-102 - Continuous Disclosure Obligations, registered and beneficial shareholders may elect annually to receive a copy of our annual financial statements and corresponding management discussion and analysis ("MD&A") or interim financial statements and the corresponding MD&A, or both.
If you wish to receive these documents by mail, please return this completed form to:
TSX Trust Company
301 - 100 Adelaide Street West
Toronto ON M5H 4H1
or fax to 416-595-9593
Rather than receiving the financial statements by mail, you may choose to view these documents on the SEDAR website at www.sedar.com.
Please send me: | ☐ | Annual Financial Statements with MD&A |
| ☐ | Interim Financial Statements with MD&A |
PLEASE PRINT
FIRST NAME | LAST NAME |
ADDRESS | |
CITY | PROVINCE/ STATE | POSTAL / ZIP CODE |
COUNTRY |
SIGNED: |
(Signature of Shareholder)