CONVERSION NOTICE. The undersigned holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ ________________________________________ ________________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any If only a portion of the Notes is to be converted, please indicate:
Appears in 2 contracts
Sources: Indenture (Ibasis Inc), Indenture (Ibasis Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 $1,000 in principal amount or an integral multiple of U.S.$1,000 in excess thereof$1,000), PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Class A common stock of Lama▇ ▇▇▇ertising Company, $0.001 par value per share (the "Common Stock Stock"), in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be issued and delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes any portion of this Note not converted are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ ________________________________________ ________________________________________ ------------------- ------------------------------------ ------------------------------------ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _______________________________ ---------------------------------- Name _______________________________ ---------------------------------- Address _______________________________ ---------------------------------- Social Security or other Other Taxpayer Identification Number, if any Number ---------------------------------- [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:: 1. Principal amount to be converted: $ ------------
Appears in 2 contracts
Sources: First Supplemental Indenture (Lamar Advertising Co/New), First Supplemental Indenture (Lamar Advertising Co/New)
CONVERSION NOTICE. The undersigned holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ ________________________________________ ________________________________________ ------------------------------- ------------------------------------- ------------------------------------- Signature(s) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ --------------------------------------- Name _______________________________ --------------------------------------- Address _______________________________ --------------------------------------- Social Security or other Identification Number, if any --------------------------------------- Signature Guaranteed If only a portion of the Notes is to be converted, please indicate:
Appears in 2 contracts
Sources: Indenture (Ibasis Inc), Indenture (Ibasis Inc)
CONVERSION NOTICE. If (i) Registered Security or (ii) Bearer Security of denomination U.S. $10,000: The undersigned holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any an integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock of Thermo Fibertek Inc. (the "Company") in accordance with the terms of the Indenture referred to in this NoteSecurity, and (ii) directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered (if a Registered Security) in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Notethereto. Dated: ___________________________ __________________________________ Signature [MUST BE GUARANTEED IF STOCK IS TO BE ISSUED IN A NAME OTHER THAN THE REGISTERED HOLDER OF THE SECURITY] If shares are to be registered in the name of and delivered to a person other than the holder, please print such person's name and address and, if this is a Restricted Security, complete the Transfer Notice: ________________________________ ________________________________ ________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holder, please HOLDER Please print such Person's name and addressaddress of holder: ________________________________ Name ________________________________ Address ________________________________ Social Security or other Identification Number, if any If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
CONVERSION NOTICE. To: IOMEGA CORPORATION The undersigned holder registered owner of this Note hereby irrevocably exercises the option to convert this Note, or any the portion of the principal amount hereof (which is U.S.$1,000 $1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock of Iomega Corporation in accordance with the terms of the Indenture referred to in this Note, and directs that the shares issuable and deliverable upon such sharesconversion, together with a any check in payment for any fractional share shares and any Notes representing any unconverted principal amount hereof, be issued and delivered to and be the registered in the name of the undersigned holder hereof unless a different name has been indicated below. If shares or any portion of Common Stock or Notes this Note not converted are to be registered issued in the name of a Person person other than the undersigned, (a) the undersigned will check the appropriate box below and pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934thereto. Any amount required to be paid by to the undersigned on account of interest accompanies this Note. Dated: ________________________ ________________________________________ ________________________________________ Signature(s) If Signature(s) must be guaranteed by an eligible Guarantor Institution (banks, stock brokers, savings and loan associations and credit unions) with membership in an approved signature guarantee medallion program pursuant to Securities and Exchange Commission Rule 17Ad-15 if shares or Notes of Common Stock are to be registered issued, or Notes to be delivered, other than to and in the name of a Person the registered holder. Fill in for registration of shares of Common Stock if to be issued, and Notes if to be delivered, other than to and in the name of the registered holder, please print such Person's name and address: _______________________________ Name (Name) _______________________________ Address (▇▇▇▇▇▇ ▇▇▇▇▇▇▇) _______________________________ (City, State and Zip Code) Please print name and address Principal amount to be converted (if less than all): $_____________ __________________________________ Social Security or other Other Taxpayer Identification Number, if any If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Iomega Corp)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the aggregate principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such aggregate principal amount is U.S. $1,000 U.S.$1,000 or any integral multiple of U.S. $1,000 U.S.$1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted aggregate principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: :______________________________ _______________________________ Signature(s) If shares or Securities are to be registered in the name of a Person other than the Holder, please print such Person's name and address: ___________________________________ (Name) ___________________________________ ____________________________________________ Signature(s(Address) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any ____________________________________________ [Signature Guaranteed] If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated:____________ ______________________________________________ Signature(s) If shares or Securities are to be registered in the name of a Person other than the Holder, please print such Person's name and address: ____________________________________________ (Name) ____________________________________________ ____________________________________________ Signature(s(Address) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any Signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad - 15 under the Securities Exchange Act of 1934. ____________________________________________ [Signature Guaranteed] If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Teradyne Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ __________:______________________________ ________________________________________ -------------------------------- -------------------------------- Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _______________________________ ------------------------------- Name _______________________________ ------------------------------- Address _______________________________ ------------------------------- Social Security or other Identification Number, if any ------------------------------- Signature Guaranteed If only a portion of the Notes is to be converted, please indicate:
1. Principal amount to be converted: U.S. $ -----------
2. Principal amount and denomination of Notes representing unconverted principal amount to be issued: Amount U.S. $ ----------- (U.S.$1,000 or any integral multiple of U.S.$1,000 in excess thereof, provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof)
Appears in 1 contract
Sources: First Supplemental Indenture (Mindspring Enterprises Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the aggregate principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such aggregate principal amount is U.S. $1,000 U.S.$1,000 or any integral multiple of U.S. $1,000 U.S.$1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted aggregate principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: _____________________ ________________________________________ ________________________________________ Signature(s) If shares or Notes Securities are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _______________________________ Name (Name) _______________________________ Address _______________________________ (Address) _______________________________ Social Security or other Identification Number, if any _______________________________ [Signature Guaranteed] If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Collegiate Pacific Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 $1,000 in principal amount or an integral multiple of U.S.$1,000 in excess thereof$1,000), PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Class A common stock of ▇▇▇▇▇ Advertising Company, $0.001 par value per share (the "Common Stock Stock"), in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be issued and delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes any portion of this Note not converted are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: ____:_________________ ________________________________________ ________________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: ________________________________ Name ________________________________ Address ________________________________ Social Security or other Other Taxpayer Identification Number, if any Number ________________________________ [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
Sources: First Supplemental Indenture (Lamar Advertising Co/New)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereofU.S.$1,000) below designated, into shares of Common Stock of the Company in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share shares and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934thereto. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: _:____________________ ---------------------------------------- ---------------------------------------- Signature(s) If shares or Securities are to be Signature(s) must be guaranteed by a registered in the name of a Person commercial bank or trust company or a other than the Holder, please print member firm of a major stock exchange such Person's name and address: with membership in an approved signature guarantee medallion program pursuant to the Securities and Exchange Commission ----------------------------------- Rule 17Ad-15 if shares of Common Stock Name are to be issued, or Securities to be delivered, other than to or in the name of the registered Holder. ----------------------------------- Address ---------------------------------------- Signature Guaranteed ----------------------------------- If only a portion of the Security is Social Security or other Taxpayer to be converted, please indicate: Identification Number, if any Principal amount to be converted: U.S.$________________________________________ ________________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Veritas Software Corp)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereofU.S.$1,000) below designated, into shares of Common Stock of the Company in accordance with the terms of the Indenture 31 39 referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share shares and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934thereto. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: _____________________ ________________________________________ ________________________________________ Dated:--------------------- --------------------------- --------------------------- Signature(s) If shares or Notes Securities are to be If only a portion of the Security is registered in the name of a Person to be converted, please indicate: other than the holderHolder, please print such Person's name and address: _______________________________ Principal amount to be converted: U.S.$ ----------------------------- ---------------------------- Name _______________________________ ----------------------------- Address _______________________________ ----------------------------- Social Security or other Taxpayer Identification Number, if any If only Signature(s) must be guaranteed by a portion commercial bank or trust company or a member firm of a major stock exchange with membership in an approved signature guarantee medallion program pursuant to the Notes is Securities and Exchange Commission Rule 17Ad-15 if shares of Common Stock are to be convertedissued, please indicate:or
Appears in 1 contract
Sources: Indenture (Veritas Software Corp)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 U.S. $1,000 or an integral multiple of U.S.$1,000 U.S. $1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: _____________________ ________________________________________ ________________________________________ ------------- --------------------------- Signature(s) If shares or Notes Securities are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ -------------------------- (Name) -------------------------- -------------------------- (Address) -------------------------- Social Security or other Identification Number, if any -------------------------- [Signature Guaranteed] If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount Original Principal Amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount Original Principal Amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share share, any other amounts payable to the Holder in connection with such conversion and any Notes representing any unconverted principal amount Original Principal Amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Notes Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ __________________:______________________ ________________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: __________________________________________________ Name __________________________________________________ Address (Address) __________________________________________________ Social Security or other Identification Number, if any __________________________________________________ (Signature Guaranteed) If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated:___________ ______________________________________________________ Signature(s) If shares or Securities are to be registered in the name of a Person other than the Holder, please print such Person's name and address: __________________________________________ (Name) __________________________________________ __________________________________________ Signature(s(Address) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any __________________________________________ Signature Guaranteed If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
Sources: Security Agreement (Bea Systems Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ __________:______________________________ ________________________________________ -------------------------------- -------------------------------- Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _______________________________ ------------------------------- Name _______________________________ ------------------------------- Address _______________________________ ------------------------------- Social Security or other Identification Number, if any ------------------------------- [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:
1. Principal amount to be converted: U.S. $ -----------
2. Principal amount and denomination of Notes representing unconverted principal amount to be issued: Amount U.S. $ ----------- (U.S.$1,000 or any integral multiple of U.S.$1,000 in excess thereof, provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof)
Appears in 1 contract
Sources: First Supplemental Indenture (Mindspring Enterprises Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 $1,000 in principal amount or an integral multiple of U.S.$1,000 in excess thereof$1,000), PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Class A common stock of Lama▇ ▇▇▇ertising Company, $0.001 par value per share (the "Common Stock Stock"), in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be issued and delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes any portion of this Note not converted are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ ________________________________________ ________________________________________ Dated --------------- -------------------------------- -------------------------------- Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _______________________________ ---------------------------------- Name _______________________________ ---------------------------------- Address _______________________________ ---------------------------------- Social Security or other Other Taxpayer Identification Number, if any Number ---------------------------------- [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
Sources: First Supplemental Indenture (Lamar Advertising Co/New)
CONVERSION NOTICE. If (i) Registered Security or (ii) Bearer Security of denomination U.S. $10,000: The undersigned holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any an integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock of ThermoLase Corporation (the "Company") in accordance with the terms of the Indenture referred to in this NoteSecurity, and (ii) directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered (if a Registered Security) in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934thereto. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Signature [MUST BE GUARANTEED IF STOCK IS TO BE ISSUED IN A NAME OTHER THAN THE REGISTERED HOLDER OF THE SECURITY] Dated: _____________________ _____________If shares or Securities are to be registered in the name of a Person other than the registered holder, please print such person's name and address and, if this is a Restricted Security, complete Transfer Notice: ___________________________ ___________________________ ___________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holder, please HOLDER Please print such Person's name and addressaddress of holder: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 $1,000 in principal amount or an integral multiple of U.S.$1,000 in excess thereof$1,000), PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Class A common stock of ▇▇▇▇▇ Advertising Company, $0.001 par value per share (the "Common Stock Stock"), in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be issued and delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes any portion of this Note not converted are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ ________ _________________________________ ________________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _________________________________ Name _________________________________ Address _________________________________ Social Security or other Other Taxpayer Identification Number, if any Number _________________________________ [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
Sources: First Supplemental Indenture (Lamar Advertising Co/New)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _________________________________________________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the Holder, please print such Person's name and address: ______________________________________________ (Name) ______________________________________________ ______________________________________________ Signature(s(Address) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any ______________________________________________ [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Orion Power Holdings Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated:____________ ______________________________________________________ Signature(s) If shares or Securities are to be registered in the name of a Person other than the Holder, please print such Person's name and address: _____________________ _______________ (Name) ___________________________________ ___________________________________ (Address) ______ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any ___________________________________ [Signature Guaranteed] If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Atmi Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount Principal Amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount Principal Amount is U.S. $1,000 U.S.$1,000 or any integral multiple of U.S. $1,000 U.S.$1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share share, any other amounts payable to the Holder in connection with such conversion and any Notes representing any unconverted principal amount Principal Amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Notes Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: Signature(s) If shares or Notes are to be registered in the name of a Person other than the Holder, please print such Person’s name and address: Name _____________________ ________________________________________ ____________________________________________________________ Signature(s(Address) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any ____________________________________________________________ (Signature Guaranteed) If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 U.S. $1,000 or an integral multiple of U.S.$1,000 U.S. $1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: _____________________ ______________________________________________ Signature(s) If shares or Securities are to be registered in the name of a Person other than the Holder, please print such Person's name and address: _______________________________________ (Name) ____________________________________________ Signature(s(Address) If shares or Notes are to be registered in the name of a Person other than the holder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any Signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad - 15 under the Securities Exchange Act of 1934. ____________________________________________ [Signature Guaranteed] If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Medarex Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereofU.S.$1,000) below designated, into shares of Common Stock of the Company in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share shares and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934thereto. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: ___________________ ___ ________________________________________ _________________________________________ Signature(s) If shares or Notes Securities are to be registered If only a portion of the Security is to be in the name of a Person other than the holderconverted, please indicate: Holder, please print such Person's name and address: ___________Principal amount to be converted: ------------------------------------------- U.S.$____________________ Name ___________________________________________ Address ___________________________________________ Social Security or other Taxpayer Identification Number, if any If only Signature(s) must be guaranteed by a portion commercial bank or trust company or a member firm of a major stock exchange with membership in an approved signature guarantee medallion program pursuant to the Securities and Exchange Commission Rule 17Ad-15 if shares of Common Stock are to be issued, or Securities to be delivered, other than to or in the name of the Notes is to be converted, please indicate:registered Holder._______________________. Signature Guaranteed
Appears in 1 contract
Sources: Indenture (Ventro Corp)
CONVERSION NOTICE. The undersigned holder Holder of this Note Security hereby irrevocably exercises the option to convert this NoteSecurity, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED U.S. $1,000 provided that the unconverted portion of such principal amount is U.S. $1,000 or any an integral multiple of U.S. $1,000 in excess thereof1,000) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this NoteSecurity, and directs that such shares, together with a check in payment for any fractional share and any Notes Securities representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes Securities are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this NoteSecurity. Dated: ___:__________________ ________________________ Signature(s) If shares or Securities are to be registered in the name of a Person other than the Holder, please print such Person's name and address: _______________________ (Name) _______________________ ________________________________________ Signature(s(Address) If shares Social Security or Notes are to be registered in the name of a Person other than the holderIdentification Number, please print such Person's name and address: ________if any _______________________ Name _______________________________ Address _______________________________ Social Security or other Identification Number, if any [Signature Guaranteed] If only a portion of the Notes Securities is to be converted, please indicate:
Appears in 1 contract
Sources: Indenture (Sonus Networks Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED provided that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: _____________________ ________________________________________ ________________________________________ ------------ ---------------------------------------------------------- Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: _______________________________ Name _______________________________ Address _______________________________ -------------------------------- (Name) -------------------------------- -------------------------------- (Address) -------------------------------- Social Security or other Identification Number, if any -------------------------------- [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert delivers this Note, or any portion of the principal amount hereof (which is U.S.$1,000 or an integral multiple of U.S.$1,000 in excess thereof, PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, Note for conversion into shares of Common Stock in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all applicable transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required Dated: _________________ ______________________________________________ Signature(s)* Signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. ______________________________________________ Signature Guaranteed If shares or Notes are to be paid by registered in the undersigned on account name of interest accompanies this Note. Dateda Person other than the Holder, please print such Person's name and address: Name: ________________________________________ Address: ________________________________________ ________________________________________ ________________________________________ Signature(s) If shares Social Security or Notes are to be registered in the name of a Person other than the holderIdentification Number, please print such Person's name and address: _______________if any:________________ Name _______________________________ Address _______________________________ Social Security *NOTICE: The signature to the foregoing Election must correspond to the name as written upon the face of this Note in every particular, without alteration or other Identification Number, if any If only a portion of the Notes is to be converted, please indicate:change whatsoever.
Appears in 1 contract
Sources: Indenture (Timco Engine Center Inc)
CONVERSION NOTICE. The undersigned holder Holder of this Note hereby irrevocably exercises the option to convert this Note, or any portion of the principal amount hereof (which is U.S.$1,000 $1,000 in principal amount or an integral multiple of U.S.$1,000 in excess thereof$1,000), PROVIDED that the unconverted portion of such principal amount is U.S. $1,000 or any integral multiple of U.S. $1,000 in excess thereof) below designated, into shares of common stock of Providian Financial Corporation, $0.01 par value per share (the "Common Stock Stock"), in accordance with the terms of the Indenture referred to in this Note, and directs that such shares, together with a check in payment for any fractional share and any Notes representing any unconverted portion of the principal amount hereof, be issued and delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If shares of Common Stock or Notes any portion of this Note not converted are to be registered in the name of a Person other than the undersigned, (a) the undersigned will pay all transfer taxes payable with respect thereto and (b) signature(s) must be guaranteed by an Eligible Guarantor Institution with membership in an approved signature guarantee program pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934. Any amount required to be paid by the undersigned on account of interest accompanies this Note. Dated: ____Dated _________________ ______________________________________________ ______________________________________________ Signature(s) If shares or Notes are to be registered in the name of a Person other than the holderHolder, please print such Person's name and address: ____________________________________ Name ____________________________________ Address ____________________________________ Social Security or other Other Taxpayer Identification Number, if any Number ____________________________________ [Signature Guaranteed] If only a portion of the Notes is to be converted, please indicate:
Appears in 1 contract
Sources: First Supplemental Indenture (Providian Financial Corp)