6-K 1 rcard2004.htm RETURN CARD Affidavit


FORM 6-K

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549


Report of Foreign Issuer
Pursuant to Rule 13a-16 or 15d-16
of the Securities Exchange Act of 1934


Terra Nova Gold Corp.
(Translation of registrant’s name into English)

3rd Floor, 157 Alexander Street, Vancouver, BC Canada V6A 1B8
(Address of principal executive officer)

Indicate by check mark whether the registrant files or will file annual reports under cover Form 20-F or Form 40-F.


Form 20-F ü        Form 40-F ________

Indicate by check mark whether the registrant by furnishing the information contained in this Form is also thereby furnishing the information to the Commission pursuant to Rule 12g3-2(b) under the Securities Exchange Act of 1934.

Yes ________        No: : ü    

If "Yes" is marked, indicate below the file number assigned to the registrant in connection with Rule 12g3-2(b): 82-_________.


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.



Terra Nova Gold Corp.
                Registrant



Dated: November 17, 2004                                                              By :    /s/David Patterson/s/    
              Title:     Chairman

 
 
     
 

TERRA NOVA GOLD CORP.

Request for Interim Financial Statements


In accordance with National Instrument 54-102 of the Canadian Securities Administrators, registered and beneficial shareholders of Terra Nova Gold Corp. (the “Company”) may elect annually to receive interim corporate mailings, including interim financial statements of the Company, if they so request. If you wish to receive such mailings, please complete and return this form to:

Terra Nova Gold Corp.
3rd Floor, 157 Alexander Street
Vancouver, BC
V6A 1B8




NAME:   _____________________________________________________________

ADDRESS:   _____________________________________________________________

   _____________________________________________________________

POSTAL CODE:   ___________________________



I confirm that I am an owner of common shares of the Company.


SIGNATURE OF
SHAREHOLDER:   ______________________________________DATE:____________