Common use of Form of Clause in Contracts

Form of. ELECTION TO PURCHASE (To be executed and delivered to the Company upon exercise of a Warrant after the Exercise Date and prior to the Expiration Date) The undersigned hereby irrevocably elects to exercise _____ of the ________ Warrants evidenced by the attached Warrant Certificate to purchase Warrant Shares, and herewith tenders payment for such Warrant Shares in an amount determined in accordance with the terms of the Warrant Agreement. The undersigned requests that a certificate representing such Warrant Shares be registered in the name of ________________, whose address is ________________, and that such certificate be delivered to ________________, whose address is ____________. If said number of Warrants is less than the number of Warrants evidenced by the Warrant Certificate, the undersigned requests that a new Warrant Certificate evidencing the number of Warrants evidenced by this Warrant Certificate that are not being exercised be registered in the name of ________________, whose address is ________________ and that such Warrant Certificate be delivered to ________________, whose address is ________________. Dated , Name of holder of Warrant Certificate: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and if the certificate evidencing the Warrant Shares or any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which this Warrant Certificate is registered, the signature above must be guaranteed. Signature Guaranteed: Dated: ________________ FORM OF ASSIGNMENT For value received, ________________hereby sells, assigns and transfers unto ________________ , ________________of the Warrants evidenced by the attached Warrant Certificate, together with all right, title and interest therein, and does hereby irrevocably constitute and appoint ________________ as its due and lawful attorney, to register the transfer of said Warrants on the books of Moscow CableCom Corp., and to execute a new Warrant Certificate in the name of ________________ whose address is ________________ evidencing the number of Warrants so sold, assigned and transferred hereby. If the number of Warrants sold, assigned or transferred hereunder is less than the number of Warrants evidenced by the attached Warrant Certificate, then the undersigned requests that a new Warrant Certificate for an amount of Warrants equal to the number of Warrants evidenced by the attached Warrant Certificate that were not sold, transferred or assigned be registered in the name of the undersigned. _____________ hereby consents to be bound by the covenants and provisions of the Warrant Agreement, dated as of [ ], by and between Moscow CableCom Corp. and Columbus Nova Investments VIII Ltd. Dated ________________, Name of holder of Warrant Certificate: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and such signature must be guaranteed. Signature Guaranteed: Dated:

Appears in 1 contract

Samples: Form of Warrant Agreement (Moscow Cablecom Corp)

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Form of. ELECTION TO PURCHASE (To be executed and delivered Election to the Company upon exercise of a Warrant after the Exercise Date and prior to the Expiration Date) Purchase The undersigned hereby irrevocably elects to exercise _____ of the ________ of the Class C Warrants evidenced by the attached Warrant Certificate to purchase Warrant Shares, and herewith tenders (or is concurrently tendering) payment for such Warrant Shares in an amount determined in accordance with the terms of the Warrant Agreement. The undersigned requests that a certificate representing such Warrant Shares be registered in the name of ________________, whose address is ________________, and that such certificate be delivered to ________________, whose address is ____________. If said number of Warrants is less than the number of Warrants evidenced by the Warrant CertificateCertificate (as calculated pursuant to the Warrant Agreement), the undersigned requests that a new Warrant Certificate evidencing the number of Warrants evidenced by this Warrant Certificate that are not being exercised be registered in the name of ________________, whose address is ________________ and that such Warrant Certificate be delivered to ________________, whose address is ________________------------------------------------------------------------------- . Dated Dated: , ------------------------------ ------------- Name of holder of Warrant Certificate: ________________ ________________ ---------------------------------------------------- ---------------------------------------------------- (Please Print) Address: ________________ ________________ --------------------------------------- --------------------------------------- Federal Tax ID No.: ________________ ----------------------------- Signature: ________________ --------------------------------------- Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and if the certificate evidencing the Warrant Shares or any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which this Warrant Certificate is registered, the signature above must be guaranteed. Signature Guaranteed: Dated: ________________ FORM OF ASSIGNMENT For value received, ________________hereby sells, assigns and transfers unto ________________ , ________________of the Warrants evidenced by the attached Warrant Certificate, together with all right, title and interest therein, and does hereby irrevocably constitute and appoint ________________ as its due and lawful attorney, to register the transfer of said Warrants on the books of Moscow CableCom Corp., and to execute a new Warrant Certificate in the name of ________________ whose address is ________________ evidencing the number of Warrants so sold, assigned and transferred hereby. If the number of Warrants sold, assigned or transferred hereunder is less than the number of Warrants evidenced by the attached Warrant Certificate, then the undersigned requests that a new Warrant Certificate for an amount of Warrants equal to the number of Warrants evidenced by the attached Warrant Certificate that were not sold, transferred or assigned be registered in the name of the undersigned. _____________ hereby consents to be bound by the covenants and provisions of the Warrant Agreement, dated as of [ ], by and between Moscow CableCom Corp. and Columbus Nova Investments VIII Ltd. Dated ________________, Name of holder of Warrant Certificate: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and such signature must be guaranteed. Signature Guaranteed: Dated:

Appears in 1 contract

Samples: Warrant Agreement (American Goldrush Corp)

Form of. ELECTION TO PURCHASE (To be executed and delivered Election to the Company upon exercise of a Warrant after the Exercise Date and prior to the Expiration Date) Purchase The undersigned hereby irrevocably elects to exercise _____ of the ________ of the Class A Warrants evidenced by the attached Warrant Certificate to purchase Warrant Shares, and herewith tenders (or is concurrently tendering) payment for such Warrant Shares in an amount determined in accordance with the terms of the Warrant Agreement. The undersigned requests that a certificate representing such Warrant Shares be registered in the name of ________________, whose address is ________________, and that such certificate be delivered to ________________, whose address is ____________. If said number of Warrants is less than the number of Warrants evidenced by the Warrant CertificateCertificate (as calculated pursuant to the Warrant Agreement), the undersigned requests that a new Warrant Certificate evidencing the number of Warrants evidenced by this Warrant Certificate that are not being exercised be registered in the name of ________________, whose address is ________________ and that such Warrant Certificate be delivered to ________________, whose address is ________________------------------------------------------------------------------- . Dated Dated: , -------------------------------- ------------- Name of holder of Warrant Certificate: ________________ ________________ ----------------------------------------------------- ----------------------------------------------------- (Please Print) Address: ________________ ________________ --------------------------------------- --------------------------------------- Federal Tax ID No.: ________________ --------------------------------- Signature: ________________ --------------------------------------- Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and if the certificate evidencing the Warrant Shares or any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which this Warrant Certificate is registered, the signature above must be guaranteed. Signature Guaranteed: Dated: ________________ FORM OF ASSIGNMENT For value received, ________________hereby sells, assigns and transfers unto ________________ , ________________of the Warrants evidenced by the attached Warrant Certificate, together with all right, title and interest therein, and does hereby irrevocably constitute and appoint ________________ as its due and lawful attorney, to register the transfer of said Warrants on the books of Moscow CableCom Corp., and to execute a new Warrant Certificate in the name of ________________ whose address is ________________ evidencing the number of Warrants so sold, assigned and transferred hereby. If the number of Warrants sold, assigned or transferred hereunder is less than the number of Warrants evidenced by the attached Warrant Certificate, then the undersigned requests that a new Warrant Certificate for an amount of Warrants equal to the number of Warrants evidenced by the attached Warrant Certificate that were not sold, transferred or assigned be registered in the name of the undersigned. _____________ hereby consents to be bound by the covenants and provisions of the Warrant Agreement, dated as of [ ], by and between Moscow CableCom Corp. and Columbus Nova Investments VIII Ltd. Dated ________________, Name of holder of Warrant Certificate: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and such signature must be guaranteed. Signature Guaranteed: Dated:

Appears in 1 contract

Samples: Warrant Agreement (American Goldrush Corp)

Form of. ELECTION TO PURCHASE (To be executed and delivered Election to the Company upon exercise of a Warrant after the Exercise Date and prior to the Expiration Date) Purchase The undersigned hereby irrevocably elects to exercise _____ of the ________ of the Warrants evidenced by the attached Warrant Certificate to purchase Warrant Shares, and herewith tenders (or is concurrently tendering) payment for such Warrant Shares in an amount determined in accordance with the terms of the Warrant Agreement. The undersigned requests that a certificate representing such Warrant Shares be registered in the name of ________________, whose address is ________________, and that such certificate be delivered to ________________, whose address is ____________. If said number of Warrants is less than the number of Warrants evidenced by the Warrant CertificateCertificate (as calculated pursuant to the Warrant Agreement), the undersigned requests that a new Warrant Certificate evidencing the number of Warrants evidenced by this Warrant Certificate that are not being exercised be registered in the name of ________________, whose address is ________________ and that such Warrant Certificate be delivered to ________________, whose address is ________________. Dated Dated: , Name of holder of Warrant Certificate: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and if the certificate evidencing the Warrant Shares or any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which this Warrant Certificate is registered, the signature above must be guaranteed. Signature Guaranteed: Dated: _________________________ FORM OF ASSIGNMENT For value received, ________________hereby sells, assigns and transfers unto ________________ , ________________of the Warrants evidenced by the attached Warrant Certificate, together with all right, title and interest therein, and does hereby irrevocably constitute and appoint ________________ as its due and lawful attorney, to register the transfer of said Warrants on the books of Moscow CableCom Corp., and to execute a new Warrant Certificate in the name of ________________ whose address is ________________ evidencing the number of Warrants so sold, assigned and transferred hereby. If the number of Warrants sold, assigned or transferred hereunder is less than the number of Warrants evidenced by the attached Warrant Certificate, then the undersigned requests that a new Warrant Certificate for an amount of Warrants equal to the number of Warrants evidenced by the attached Warrant Certificate that were not sold, transferred or assigned be registered in the name of the undersigned. _____________ hereby consents to be bound by the covenants and provisions of the Warrant Agreement, dated as of [ ], by and between Moscow CableCom Corp. and Columbus Nova Investments VIII Ltd. Dated ________________, Name of holder of Warrant CertificateDated: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and such signature must be guaranteed. Signature Guaranteed: Dated:,

Appears in 1 contract

Samples: Warrant Agreement (Tuffnell Ltd.)

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Form of. ELECTION TO PURCHASE (To be executed and delivered Election to the Company upon exercise of a Warrant after the Exercise Date and prior to the Expiration Date) Purchase The undersigned hereby irrevocably elects to exercise _____ of the ________ of the Class ___-1 Warrants evidenced by the attached Warrant Certificate to purchase Warrant Shares, and herewith tenders (or is concurrently tendering) payment for such Warrant Shares in an amount determined in accordance with the terms of the Warrant Agreement. The undersigned requests that a certificate representing such Warrant Shares be registered in the name of _____________________, whose address is is________________, ________________________________ and that such certificate be delivered to _______________________, whose address is _______________________________________. If said number of Warrants is less than the number of Warrants evidenced by the Warrant CertificateCertificate (as calculated pursuant to the Warrant Agreement), the undersigned requests that a new Warrant Certificate evidencing the number of Warrants evidenced by this Warrant Certificate that are not being exercised be registered in the name of ____________________, whose address is _________________________________________ and that such Warrant Certificate be delivered to ________________________, whose address is ________________. Dated , Name of holder of Warrant Certificate: ________________ ________________ _______________. Dated: , 200 --------------------------------- ----- Name of holder of Warrant Certificate: -------------------------------------------------- -------------------------------------------------- (Please Print) Address: ________________ ________________________ --------------------------------------- Federal Tax ID No.: _____________________________ Signature: ______________________________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and if the certificate evidencing the Warrant Shares or any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which this Warrant Certificate is registered, the signature above must be guaranteed. Signature Guaranteed: Dated: ________________ FORM OF ASSIGNMENT For value received, ________________hereby sells, assigns and transfers unto ________________ , ________________of the Warrants evidenced by the attached Warrant Certificate, together with all right, title and interest therein, and does hereby irrevocably constitute and appoint ________________ as its due and lawful attorney, to register the transfer of said Warrants on the books of Moscow CableCom Corp., and to execute a new Warrant Certificate in the name of ________________ whose address is ________________ evidencing the number of Warrants so sold, assigned and transferred hereby. If the number of Warrants sold, assigned or transferred hereunder is less than the number of Warrants evidenced by the attached Warrant Certificate, then the undersigned requests that a new Warrant Certificate for an amount of Warrants equal to the number of Warrants evidenced by the attached Warrant Certificate that were not sold, transferred or assigned be registered in the name of the undersigned. _____________ hereby consents to be bound by the covenants and provisions of the Warrant Agreement, dated as of [ ], by and between Moscow CableCom Corp. and Columbus Nova Investments VIII Ltd. Dated ________________, Name of holder of Warrant Certificate: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and such signature must be guaranteed. Signature Guaranteed: Dated:

Appears in 1 contract

Samples: Warrant Agreement (Patriot Gold Corp)

Form of. ELECTION TO PURCHASE (To be executed and delivered Election to the Company upon exercise of a Warrant after the Exercise Date and prior to the Expiration Date) Purchase The undersigned hereby irrevocably elects to exercise _____ of the ________ of the Class B Warrants evidenced by the attached Warrant Certificate to purchase Warrant Shares, and herewith tenders (or is concurrently tendering) payment for such Warrant Shares in an amount determined in accordance with the terms of the Warrant Agreement. The undersigned requests that a certificate representing such Warrant Shares be registered in the name of ________________, whose address is ________________, and that such certificate be delivered to ________________, whose address is ____________. If said number of Warrants is less than the number of Warrants evidenced by the Warrant CertificateCertificate (as calculated pursuant to the Warrant Agreement), the undersigned requests that a new Warrant Certificate evidencing the number of Warrants evidenced by this Warrant Certificate that are not being exercised be registered in the name of ________________, whose address is ________________ and that such Warrant Certificate be delivered to ________________, whose address is ________________------------------------------------------------------------------- . Dated Dated: , --------------------------------- ------- Name of holder of Warrant Certificate: ________________ ________________ -------------------------------------------------- -------------------------------------------------- (Please Print) Address: ________________ ________________ --------------------------------------- --------------------------------------- Federal Tax ID No.: ________________ ----------------------------- Signature: ________________ --------------------------------------- Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and if the certificate evidencing the Warrant Shares or any Warrant Certificate representing Warrants not exercised is to be registered in a name other than that in which this Warrant Certificate is registered, the signature above must be guaranteed. Signature Guaranteed: Dated: ________________ FORM OF ASSIGNMENT For value received, ________________hereby sells, assigns and transfers unto ________________ , ________________of the Warrants evidenced by the attached Warrant Certificate, together with all right, title and interest therein, and does hereby irrevocably constitute and appoint ________________ as its due and lawful attorney, to register the transfer of said Warrants on the books of Moscow CableCom Corp., and to execute a new Warrant Certificate in the name of ________________ whose address is ________________ evidencing the number of Warrants so sold, assigned and transferred hereby. If the number of Warrants sold, assigned or transferred hereunder is less than the number of Warrants evidenced by the attached Warrant Certificate, then the undersigned requests that a new Warrant Certificate for an amount of Warrants equal to the number of Warrants evidenced by the attached Warrant Certificate that were not sold, transferred or assigned be registered in the name of the undersigned. _____________ hereby consents to be bound by the covenants and provisions of the Warrant Agreement, dated as of [ ], by and between Moscow CableCom Corp. and Columbus Nova Investments VIII Ltd. Dated ________________, Name of holder of Warrant Certificate: ________________ ________________ (Please Print) Address: ________________ ________________ Federal Tax ID No.: ________________ Signature: ________________ Note: The above signature must correspond with the name as written in the first sentence of the attached Warrant Certificate in every particular, without alteration or enlargement or any change whatever, and such signature must be guaranteed. Signature Guaranteed: Dated:

Appears in 1 contract

Samples: Warrant Agreement (American Goldrush Corp)

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