ESOP Withdrawal Form

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NUTRIEN

(PCS Nitrogen Trinidad Limited)


EMPLOYEE SHARE OWNERSHIP PLAN (ESOP)
REQUEST FOR WITHDRAWAL

Name of Member: ___________________________

Termination/Withdrawal Date: ___________________________

Reason for Withdrawal

Normal Retirement Resignation

Death Units Matured Withdrawal/leaving

I would like _______of my NUTRIEN Shares to be treated as indicated hereunder:

a) Sold at $__________________
market
Pay funds in US Currency TT Currency

b) Transferred to me
Name of Bank / Broker _______________________________________
Address ____________________________________________________
Account Number _____________________________________________
Broker’s Depository Trust Co. No. / DTC No. ______________________

c) Transferred to my nominee
Name of Transferee: __________________________________________
Address of Transferee: ________________________________________

________________ _______________________
Date Signature of Member

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