Name of Purchaser. SIGNATURE OF AUTHORIZED SIGNATORY OF PURCHASER: ________________________________ Name of Authorized Signatory: __________________________________________________ Title of Authorized Signatory: _________________________________________________ Email Address of Purchaser:_____________________________________________________ Address for Notice of Purchaser: Address for Delivery of Securities for Purchaser (if not same as above):
Name of Purchaser. Dated: By: Name: Title: Aggregate principal amount of: Purchase Money Notes due [February 25, 2012]: $ Purchase Money Notes due [February 25, 2013]: $ Purchase Money Notes due [February 25, 2014]: $ Taxpayer identification number: Address for notices: Wire transfer information for payments: Bank: Address: Bank ABA#: Account #: Telephone: FAO Facsimile: Attention: Attention: Registered Name: Delivery Instructions: This certificate and the statements contained herein are made for your benefit. [INSERT NAME OF HOLDER] By: Name: Title: Dated: , EXHIBIT D FORM OF DTC NOTICE TO INVESTORS The Depository Trust Company IMPORTANT NOTICE DATE: [ ] TO: ALL PARTICIPANTS FROM: Multibank 2009-1 CML-ADC Venture, LLC (the “Company”) Re.: Purchase Money Note due [February 25, 2012] (CUSIP No. [ ]); Purchase Money Note due [February 25, 2013] (CUSIP No. [ ]); Purchase Money Note due [February 25, 2014] (CUSIP No. [ ]); (collectively, the “Notes”) The Company referred to above is putting Participants on notice that they are required to follow these purchase and transfer restrictions with regard to the above-referenced Notes. In order to qualify for the exemption provided by Section 3(c)(7) under the Investment Company Act of 1940, as amended (the “Investment Company Act”), and the exemption provided by Rule 144A under the Securities Act of 1933, as amended (the “Securities Act”), offers, sales and resales of the above-referenced Notes within the United States or to persons that are U.S. Persons as defined in Regulation S under the Securities Act (“U.S. Persons”) or U.S. residents within the meaning of the Investment Company Act (“U.S. Residents”) may only be made in minimum denominations of U.S.$500,000 and integral multiples of U.S.$1,000 in excess thereof to “qualified institutional buyers” (“QIBs”) within the meaning of Rule 144A that are also “qualified purchasers” (“QPs”) within the meaning of Section 2(a)(51)(A) of the Investment Company Act. Each purchaser of Notes (I) represents to and agrees with the Company that (A)(i) the purchaser is a QIB that is a QP (a “QIB/QP”); (ii) the purchaser is not a broker-dealer that owns and invests on a discretionary basis less than U.S.$25 million in securities of unaffiliated issuers; (iii) the purchaser is not a pension, profit sharing or other retirement trust fund or plan in which the partners, beneficiaries or participants, as applicable, may designate the particular investments to be made, and in a transaction that may be effe...
Name of Purchaser. Dated: By: Name: Title: Outstanding principal amount of [Class [A] [B] [C] [D] [E]] [[Senior][Junior] Subordinated] Notes: $__________
Examples of Name of Purchaser in a sentence
Print Name of Purchaser By: Signature of Authorized Signatory Name of Authorized Signatory (if an entity) Title of Authorized Signatory (if an entity) CERTIFICATE OF ACCREDITED INVESTOR STATUS The signatory hereto is an “accredited investor”, as that term is defined in Regulation D under the Securities Act of 1933, as amended (the “Act”).
FORMAT 6.6 PERFORMANCE SECURITY FORM To: (Name of Purchaser) WHEREAS ...................................................................
Yours very truly, (Name of Purchaser) By: (Title) (Address) Accepted as of the date first above written.
Signature, Name and Address of witness) SECTION IX : PERFORMANCE SECURITY FORM SECTION IX: PERFORMANCE SECURITY FORM To : (Name of Purchaser) WHEREAS ..........................................................
Yours very truly, (Name of Purchaser) By (Title of Signatory) (Address of Purchaser) Accepted, as of the above date.
More Definitions of Name of Purchaser
Name of Purchaser. Dated: -------------------------- -------------------------- By: ------------------------------ Name: Title: Aggregate principal amount of: Series [ ] Notes: $ -------------- Taxpayer identification number: ---------------- Address for notices: Wire transfer information for payments: Bank: -------------------------------- Address: Bank ABA#: -------------------------------- Account #: -------------------------------- Telephone: -------------------------------- Facsimile: -------------------------------- Attention: -------------------------------- Registered name: -------------------------- EXHIBIT A-3 TO ARG II BASE INDENTURE FORM OF TRANSFER CERTIFICATE FOR TEMPORARY GLOBAL NOTE OR PERMANENT GLOBAL NOTE TO RESTRICTED GLOBAL NOTE (TRANSFEROR) [Letterhead of Transferor] Reference is hereby made to the Amended and Restated Base Indenture, dated as of [ ], 2002 (the "BASE INDENTURE"), and the Series [ ] Supplement thereto, dated as of [ ] (the "SERIES [ ] SUPPLEMENT" and together with the Base Indenture, the "INDENTURE"), each between ARG II and The Bank of New York, as trustee. Capitalized terms used but not defined herein shall have the meanings assigned to them in the Indenture. Other terms shall have the meanings assigned to them in Rule 144A under the United States Securities Act of 1933, as amended (the "SECURITIES ACT"). This letter relates to U.S. $_________ principal amount of Series [ ] Notes (the "NOTES") of ARG II which are held in the registered name of [insert name of transferor] (the "TRANSFEROR"). The Transferor has requested a transfer of such Notes to [insert name of transferee]. In connection with such request, and in respect of such Notes, the Transferor does hereby certify that such Notes are being transferred in accordance with Rule 144A under the Securities Act to a transferee that the Transferor reasonably believes is purchasing the Notes for its own account or an account with respect to which the transferee exercises sole investment discretion and the transferee and any such account is a "qualified institutional buyer" within the meaning of Rule 144A, and such transferee is aware that the sale to it is being made in reliance upon Rule 144A, and any applicable securities laws of any state of the United States or any other jurisdiction. This letter and the statements contained herein are made for the benefit of ARG II and the Trustee. [TRANSFEROR] By: ----------------------------- Name: Title: Dated: ______________, _____ EXHIBIT A-4 TO...
Name of Purchaser. Dated: By: Name: Title: Aggregate principal amount of: 26 Insert as appropriate Purchase Money Notes due [February 25, 2012]: $ Purchase Money Notes due [February 25, 2013]: $ Purchase Money Notes due [February 25, 2014]: $ EXHIBIT C-5 FORM OF CERTIFICATE FOR TRANSFER OR EXCHANGE OF GLOBAL NOTE TO CERTIFICATED NOTE Multibank 2009-1 CML-ADC Venture, LLC c/o Wells Fargo Bank, N.A., as Paying Agent 0xx Xxxxxx & Xxxxxxxxx Xxxxxx Xxxxxxxxxxx, XX 00000 Attn: Corporate Trust Services Transfer Agent Department Re: Purchase Money Notes due [February 25, 2012][February 25, 2013][February 25, 2014]27 Ladies and Gentlemen:
Name of Purchaser. Xxxxxx Xxxxx Address: 00 Xxxxxxxxx Xxxx #0000, Xxxxxxxx, XX 00000 Tel: (000) 000-0000 Email: Xxxxxxxxxx@xxx.xxx Name of Purchaser: XWRT2 LP Address: 000 Xxxxxx Xxxxx Avenue Kentfield, CA 94904 Attention: Xxxxxx Xxxxxx Tel: 000-000-0000 Email: xxxxxxx@xxxxxxxxx.xxx Name of Purchaser: SBMT2 LP Address: 000 X. Xxxxx Xxxxxx Xxxxxxx, XX 00000 Attention: Xxxxxxx Xxxx Tel: 000-000-0000 Email: xxxxxxxxxxx@xxxxx.xxx Name of Purchaser: Godfrey2468 LP Address: 000 Xxxxxxxxx Xxxxxx Xxxxxxxx, XX 00000 Attention: Xxxxx Xxxxxxx Tel: 000-000-0000 x 00 Email: xxxxxxx000@xxxxxxx.xxx Name of Purchaser: LeeMadison9189 LP Address: 0000 Xxxx Xxxxxxxx Xxxxxxxx Xxxxx Xxxxxxxx, XX 00000 Attention: Xxxxxx Xxxxx Tel: 000-000-0000 Email: xxx@xxxxxxxxxxxx.xxx Name of Purchaser: RossPlan LP Address: 000 X. 00xx Xxxxxx Xxx Xxxx, XX 00000 Attention: Xxxx Xxxxxxxx Tel: 000-000-0000 Email: xxxxxxxx@xxx.xxx
Name of Purchaser. Golden1177 LP Address: #000-0000 Xxxx Xxxxxxxx Xxxxxx, Xxxxxxxxx, XX X0X 0X0 Attention: Xxxx Xxxx Tel: (000) 000-0000 Email: xxxx@xxxxxxxxxxxxxxxx.xx Name of Purchaser: JBWA2 LP Address: 000 Xxxxxxxx Xxx XX, Xxxxx #0000, Xxxxxxxx, XX 00000 Attention: C. Xxxxx Xxxxxx Tel: (000) 000-0000 Email: xxxxxxxxxxx@xxx.xxx Name of Purchaser: TIBERO2 LP Address: 00 Xxxxxxxxx Xxx, Xxxxxxxxx Xxxxxxxxx XX000XX Xxxxxxx Attention: Xxx Xxxxxxxx Tel:000-000-0000 Email: xxxxxxxxxxx00@xxxxxxxxxx.xxx Name of Purchaser: KAUFMAN2 LP Address: 000 X. 00xx Xxxxxx, Xxx Xxxx, Xxx Xxxx 00000 Attention: Xxxxxx Xxxxxxx Tel: (000) 000-0000 Email: Xxxxxx.x.xxxxxxx@xxxxx.xxx EXHIBIT B PURCHASER INFORMATION Name of Purchaser Address of Purchaser Amount of Securities Purchased (US$) Purchase Amount Submitted Herewith Taxpayer ID Number/ Social Security Number EXHIBIT C
Name of Purchaser. By: ___________________________ Name: Title: Aggregate Purchase Price (Subscription Amount): $ ___________________ Number of Shares to be Acquired: Underlying Shares Subject to Warrant: (25% of the number of Shares to be acquired) Tax ID No.: ____________________ Address for Notice: _______________________________ _______________________________ _______________________________ Telephone No.: ________________________ Facsimile No.: _________________________ E-mail Address: ________________________ Attention: ____________________________ Delivery Instructions: (if different than above) c/o ________________________ Street: ______________________ City/State/Zip: ________________ Attention: ___________________ Telephone No.: ______________ EXHIBITS:
Name of Purchaser. Sabby Volatility Warrant Master Fund, Ltd. Signature of Authorized Signatory: Name of Authorized Signatory: Xxxxxx Xxxxxxxxxx Title of Authorized Signatory: COO of Investment Manager Purchase Price: $125,000.00 Principal Amount of Notes: $125,000.00 New Warrant Shares: 5,000,000 @ $0.025 Executed as of the first date written above by the undersigned duly authorized representatives of the Company and the Purchaser: GEOVAX LABS, INC. By: Name: Title:
Name of Purchaser. Sabby Healthcare Master Fund, Ltd. Signature of Authorized Signatory: Name of Authorized Signatory: Xxxxxx Xxxxxxxxxx Title of Authorized Signatory: COO of Investment Manager Purchase Price: $125,000.00 Principal Amount of Notes: $125,000.00 New Warrant Shares: 5,000,000 @ $0.025