Employee Share Ownership Plan

New Enrolment / Contribution Change Form

Colleague Information
Last name, First name (please print) Colleague ID# Division Social Insurance Number

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Eligibility & Contributions

Eligibility to participate in the Employee Share Ownership Plan (“ESOP” or the “Plan”) is subject to completion of six (6) months’ continuous service with
the Company. Contributions to the ESOP must be made through regular payroll deductions and cannot be made in a lump-sum. Your contributions to the
Plan will attract a matching Company contribution equal to 25% of your contributions on a per pay basis. The Company’s contribution represents a taxable
benefit to you.
Computershare Trust Company of Canada, the administrative agent of the ESOP, purchases common shares of Loblaw Companies Limited (“Shares”) on
your behalf upon receipt of contributions from the Payroll Administrator. The number of Shares purchased will depend both on total contributions (your
contributions and the Company matching contributions) and on the market price of the Shares during the purchasing period.
For additional information about the Plan, please refer to the ESOP Summary posted on Loblaw Inside. If you don’t have access to Loblaw Inside, contact
the Colleague Info Centre (“CIC”) at 1-877-303-3013 to request that a copy of the Summary be emailed or mailed to you.

Payroll Deduction Authorization

I authorize deductions from my pay as indicated (X) below. I understand that my ESOP enrolment date, payroll deductions or change to payroll deductions,
as applicable, will commence on the first available pay period following receipt of this form by the Regional CIC (or Executive Payroll Department, as
applicable).

❑ New Enrolment ❑ 1% ❑ 2% ❑ 3% ❑ 4% ❑ 5%
❑ Change or Reinstate Payroll Deductions ❑ 1% ❑ 2% ❑ 3% ❑ 4% ❑ 5%
❑ Stop Payroll Deductions

My signature on this Form grants consent for my social insurance number (SIN) to be used by Loblaw and Computershare for the purpose of
administration and compliance with all legal and tax requirements in connection with the ESOP.
I understand and agree that the personal information provided herein or collected in the future by Loblaw may be collected, used, or disclosed to
administer the group policy of which I am an eligible member. My personal information may be collected from and/or released to a third party. These third
parties may include other underwriters, institutions, government and regulatory authorities, and other third parties when required to administer benefits
under the ESOP.
I understand that my personal information will be kept confidential and secure. However, if my consent is withheld or revoked, my participation in the
ESOP may be denied. I understand why my personal information is needed and am aware of the risks of consenting or refusing to consent to its
disclosure.

Colleague Signature Date: (yyyy/mm/dd)

Submit your signed form by email, fax or inter-office mail

Atlantic, Ontario and West Region colleagues Quebec colleagues Loblaw Executives
Colleague Support Centre Colleague Support Centre
Executive Payroll Department
Loblaw Companies Limited Loblaw Companies Limited
George Weston Limited
1 President’s Choice Circle 400, avenue Ste-Croix
22 St. Clair Ave East, 8th Floor
Brampton, ON L6Y 5S5 Ville St. Laurent, Qc H4N 3L4
Toronto, ON M4T 2S7
email: cic@loblaw.ca email: cic@loblaw.ca
email: Pensions.Benefits@weston.ca
fax: 905-861-2353 / toll free 1-888-880-9166 fax: 905-861-2353 / toll free 1-888-880-9166
tel: 1-877-303-3013 tel: 1-877-303-3013 tel: 416-965-5555

CIC / Executive Payroll Use

Date Form Received (yyyy/mm/dd) Date Payroll Updated Date of Last Deduction Processed by: (Insert name of CIC or Executive Payroll Administrator)
(yyyy/mm/dd) (yyyy/mm/dd)

YOU MAKE LOBLAW GREAT!

February 2019