CONVERSION FORM Clause Samples
The Conversion Form clause defines the process and requirements for converting one type of security or instrument into another, such as converting preferred shares into common shares. Typically, this clause outlines the necessary documentation, timing, and procedural steps that a holder must follow to initiate and complete the conversion. By specifying these details, the clause ensures a clear and standardized method for executing conversions, thereby reducing confusion and disputes between parties.
CONVERSION FORM. TO: CIRCLE STAR ENERGY CORP. (the “Company”) The undersigned hereby exercises the right to convert US$____________ of the principal amount of the Amended and Restated 12% Convertible Note, due December 31, 2014 (the “Note”), registered in the name of the undersigned represented by the within certificate, into shares of common stock in the capital of the Company (“Common Stock”) at the conversion price of US$0.75 per share. The undersigned holder understands that unless the Common Stock issuable upon the conversion of the Note are registered under the 1933 Act and the securities laws of all applicable states of the United States and the undersigned has provided a written opinion of counsel satisfactory to the Company to such effect, the certificate representing the Common Stock issued upon Conversion of this Note will bear the following restrictive legend: “THE SECURITIES REPRESENTED HEREBY HAVE NOT BEEN AND WILL NOT BE REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE “U.S. SECURITIES ACT”). THESE SECURITIES MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED ONLY (A) TO THE COMPANY, (B) IF THE SECURITIES HAVE BEEN REGISTERED IN COMPLIANCE WITH THE REGISTRATION REQUIREMENTS UNDER THE U.S. SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS (C) IN COMPLIANCE WITH THE EXEMPTION FROM THE REGISTRATION REQUIREMENTS UNDER THE U.S. SECURITIES ACT IN ACCORDANCE WITH RULE 144 THEREUNDER, IF APPLICABLE, AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS, OR (D) IN A TRANSACTION THAT DOES NOT REQUIRE REGISTRATION UNDER THE U.S. SECURITIES ACT OR ANY APPLICABLE STATE LAWS AND REGULATIONS GOVERNING THE OFFER AND SALE OF SECURITIES, AND THE HOLDER HAS, PRIOR TO SUCH SALE, FURNISHED TO THE COMPANY AN OPINION OF COUNSEL OF RECOGNIZED STANDING, OR OTHER EVIDENCE OF EXEMPTION, REASONABLY SATISFACTORY TO THE COMPANY. HEDGING TRANSACTIONS INVOLVING THE SECURITIES REPRESENTED HEREBY MAY NOT BE CONDUCTED UNLESS IN COMPLIANCE WITH U.S. SECURITIES LAWS”. If the full principal amount of the Note represented by the Note certificate is not being converted, a new Note certificate will be issued and delivered with the Common Share certificates. Please issue a certificate for the Common Stock being purchased as follows in the name of the undersigned. DATED at ______________________________ this ___ day of _________________, 20__. Signature Witnessed (see instructions to Holder) Signature of Holder (to be the same as appears on the fac...
CONVERSION FORM. The undersigned hereby:
CONVERSION FORM. TO: Digital Ecosystems Corp. (Company)
CONVERSION FORM. (To be Executed by the Registered Holder to Exercise the Rights to Purchase Common Stock Evidenced by the Acquisition Credit). I, the undersigned, hereby irrevocably subscribe for, ____shares (the “Stock”) of the Common Stock of Sentient Brands Holdings, Inc. (or its successor public company) (the “Company”‘) pursuant to and in accordance with the terms and conditions of the attached Acquisition Credit and hereby make payment of $___ therefor, and request that a certificate for such securities be issued in the name of the undersigned and be delivered to the undersigned at the address stated below. If such number of securities is not all of the securities purchasable pursuant to the attached Acquisition Credit, the undersigned requests that a new Acquisition Credit of like tenor for the balance of the remaining securities purchasable thereunder be delivered to the undersigned at the address stated below. In connection with the issuance of the securities, I hereby represent to the Company that I am acquiring the securities for my own account for investment and not with a view to, or for resale in connection with, a distribution of the securities within the meaning of the Securities Act of 1933, as amended (the “Act’). I also understand that the Company has not registered the Stock under the Act in reliance upon the private offering exemptions contained in Section 4(2) of the Act and that such reliance is based in part upon my representations Date:
CONVERSION FORM. TO BioNeutral Group, Inc. ▇▇▇ ▇▇▇▇▇▇ ▇▇. Newark, New Jersey 07103 The undersigned, hereby irrevocably elects to convert the Accrued Compensation of this Agreement at a conversion price of $0.003 per share. The undersigned hereby agrees that upon conversion, the entire principal due on this Convertible Agreement shall be deemed fully paid and the Convertible Agreement will be cancelled in full. The Company shall have no obligation with respect to any principal payments after the Effective Date. NAME: _______________________________________________________________________ ADDRESS: ___________________________________________________________________ TELEPHONE: ________________________________________________________________ EMAIL: ___________________________________________________________________ AMOUNT TO BE CONVERTED $_________________________________________ DATED: ___________________________________________________________________ PRINT NAME SIGNATURE TO BioNeutral Group, Inc. ▇▇▇ ▇▇▇▇▇▇ ▇▇. Newark, New Jersey 07103 The undersigned, hereby irrevocably elects to convert the Future Compensation of this Agreement at a conversion price of $_________ per share. The undersigned hereby agrees that upon conversion, the entire principal due on this Convertible Agreement shall be deemed fully paid and the Convertible Agreement will be cancelled in full. The Company shall have no obligation with respect to any principal payments after the Effective Date. NAME: _______________________________________________________________________ ADDRESS: ___________________________________________________________________ TELEPHONE: ________________________________________________________________ EMAIL: ___________________________________________________________________ AMOUNT TO BE CONVERTED $_________________________________________ DATED: ___________________________________________________________________ PRINT NAME SIGNATURE THIS AGREEMENT made as of July 10, 2013 between BioNeutral Group, Inc. (“the Company”) and ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ (the “Secured Party”).
CONVERSION FORM. If you, the Holder, want to convert this Debenture, complete the form below.
CONVERSION FORM. 57 THIS INDENTURE made as of the 5th day of October, 1994. BETWEEN: HARMAC PACIFIC INC., a company incorporated under the laws of the Province of British Columbia, and having its head office in the City of Vancouver, in the Province of British Columbia (the "Company") AND: MONTREAL TRUST COMPANY OF CANADA, a trust company incorporated under the laws of Canada (the "Trustee") WITNESSES THAT:
CONVERSION FORM. The undersigned owner of a Convertible Term Loan Note and Convertible PIK Note, as the case may be, (collectively, the "Notes") issued by SR Telecom Inc. ("Borrower") hereby irrevocably exercises its option to convert the Notes and accrued and unpaid interest thereon into fully paid and non-assessable Common Shares in accordance with the terms of the credit agreement dated as of May 19, 2005 between Borrower, BNY Trust Company of Canada, as Administrative Agent and Collateral Agent, and the lenders party thereto, as amended, restated, modified or supplemented from time to time and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned registered holder of the Notes, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any amount required to be paid by the undersigned on account of such transfer accompanies this Conversion Notice. Dated:_______________________ Amount of Notes and accrued and unpaid interest thereon to be converted: Cdn$_________________________ Signature (for conversion only) If the Common Shares are to be issued and registered otherwise than to the undersigned, please print or typewrite name and address, including postal code/zip code, and social security, social insurance or other taxpayer identification number.
CONVERSION FORM. Date: TO: The undersigned hereby exercises the conversion privilege upon the terms and conditions set forth in the attached Debenture, to the extent of the maximum number of shares of Common Stock issuable pursuant to the terms of Sections 4 and 5 of the Debenture, and accordingly, authorizes the Company to apply $__________ principal amount of the attached Debenture to payment in full for such shares of Common Stock. Please register such shares and make delivery thereof as follows: Registered in the Name of (Giving First or Middle Name in Full) Name (Please Print) Address DELIVERY INSTRUCTIONS To be completed ONLY if Certificates are to be mailed to persons other than the Registered Holder. Name (Please Print) Address Signature ny-221336 41 ASSIGNMENT FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfer unto ___________________ ____________________________________ the within Debenture and all rights thereunder, hereby irrevocably authorizing the Company to transfer said Debenture on the books of the Company, with full power of substitution in the premises. Dated: Signature: