SSN. 2. Description of the property with respect to which the election is being made: __________________(_____) shares of Common Stock, par value $0.0001 per share, of the Company.
SSN. 2. The property with respect to which the election is being made is non-voting common stock of Xxxxxx Bancorp, Inc.
SSN. 2. Family Size;
SSN. OR EIN: __ __ -- __ __ __ __ __ __ __ Check Appropriate box: Individual/Sole Prop. Other Print name as shown on your income tax return if different from «Payee»: ________________ Under penalties of perjury, I certify that:
SSN. 3. If the Assignee is a trust, the trust's federal employer identification number, and the trust's beneficiaries and their relationship to me, are as follows: Trust EIN: -------------------------------------------------------------- Name of Beneficiary Relationship -------------------------------------------------------------- -------------------------------------------------------------- -------------------------------------------------------------- -------------------------------------------------------------- -------------------------------------------------------------- --------------------------------------------------------------
SSN. 2. A description of the property with respect to which the election is being made: [ ] Class B Interests.
SSN. It is critical that this information is correct so the money will be deposited in the correct account number at the appropriate bank. If you have questions about obtaining the correct transit or account numbers, please contact your financial institution.
SSN. 2. The property with respect to which the election is being made is common stock of S.Y. Bancorp, Inc.
SSN. 2. A description of the property with respect to which the election is being made: _______ Common Units of the Company.
SSN. 2. The property with respect to which the election under IRC § 83(b) is made is the following number of shares of Class B Common Stock (the “Common Stock”) in APTERA MOTORS CORP., a Delaware corporation (the “Company”): shares of Common Stock
