CONVERSION FORM Sample Clauses

CONVERSION FORM. The undersigned hereby:
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CONVERSION FORM. The undersigned owner of a Convertible Term Loan Note and Convertible PIK Note, as the case may be, (collectively, the "Notes") issued by SR Telecom Inc. ("Borrower") hereby irrevocably exercises its option to convert the Notes and accrued and unpaid interest thereon into fully paid and non-assessable Common Shares in accordance with the terms of the credit agreement dated as of May 19, 2005 between Borrower, BNY Trust Company of Canada, as Administrative Agent and Collateral Agent, and the lenders party thereto, as amended, restated, modified or supplemented from time to time and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned registered holder of the Notes, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any amount required to be paid by the undersigned on account of such transfer accompanies this Conversion Notice. Dated:_______________________ Amount of Notes and accrued and unpaid interest thereon to be converted: Cdn$_________________________ Signature (for conversion only) If the Common Shares are to be issued and registered otherwise than to the undersigned, please print or typewrite name and address, including postal code/zip code, and social security, social insurance or other taxpayer identification number. Schedule A
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CONVERSION FORM. TO: SKY PETROLEUM, INC. (the “Company”) The undersigned hereby exercises the right to convert US$____________ of the principal amount of the Amended and Restated 8% Convertible Note, due May 8, 2015 (the “Note”), registered in the name of the undersigned represented by the within certificate, into shares of common stock in the capital of the Company (“Common Stock”) at the conversion price of US$0.25 per share. The undersigned holder understands that unless the Common Stock issuable upon the conversion of the Note are registered under the United States Securities Act of 1933, as amended, and the securities laws of all applicable states of the United States and the undersigned has provided a written opinion of counsel satisfactory to the Company to such effect, the certificate representing the Common Stock issued upon Conversion of this Note will bear the following restrictive legend: “THE SECURITIES REPRESENTED HEREBY HAVE NOT BEEN AND WILL NOT BE REGISTERED UNDER THE UNITED STATES SECURITIES ACT OF 1933, AS AMENDED (THE “U.S. SECURITIES ACT”). THESE SECURITIES MAY BE OFFERED, SOLD, PLEDGED OR OTHERWISE TRANSFERRED ONLY (A) TO THE CORPORATION, (B) IF THE SECURITIES HAVE BEEN REGISTERED IN COMPLIANCE WITH THE REGISTRATION REQUIREMENTS UNDER THE U.S. SECURITIES ACT AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS (C) IN COMPLIANCE WITH THE EXEMPTION FROM THE REGISTRATION REQUIREMENTS UNDER THE U.S. SECURITIES ACT IN ACCORDANCE WITH RULE 144 THEREUNDER, IF APPLICABLE, AND IN ACCORDANCE WITH APPLICABLE STATE SECURITIES LAWS, OR (D) IN A TRANSACTION THAT DOES NOT REQUIRE REGISTRATION UNDER THE U.S. SECURITIES ACT OR ANY APPLICABLE STATE LAWS AND REGULATIONS GOVERNING THE OFFER AND SALE OF SECURITIES, AND THE HOLDER HAS, PRIOR TO SUCH SALE, FURNISHED TO THE CORPORATION AN OPINION OF COUNSEL OF RECOGNIZED STANDING, OR OTHER EVIDENCE OF EXEMPTION, REASONABLY SATISFACTORY TO THE CORPORATION. HEDGING TRANSACTIONS INVOLVING THE SECURITIES REPRESENTED HEREBY MAY NOT BE CONDUCTED UNLESS IN COMPLIANCE WITH U.S. SECURITIES LAWS”. If the full principal amount of the Note represented by the Note certificate is not being converted, a new Note certificate will be issued and delivered with the Common Share certificates. Please issue a certificate for the Common Stock being purchased as follows in the name of the undersigned. DATED at ______________________________ this _________ day of _________________, ______. Signature Witnessed (see instructions to Holder) Signatur...
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CONVERSION FORM. 57 THIS INDENTURE made as of the 5th day of October, 1994. BETWEEN: HARMAC PACIFIC INC., a company incorporated under the laws of the Province of British Columbia, and having its head office in the City of Vancouver, in the Province of British Columbia (the "Company") AND: MONTREAL TRUST COMPANY OF CANADA, a trust company incorporated under the laws of Canada (the "Trustee") WITNESSES THAT:
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CONVERSION FORM. Date: TO: The undersigned hereby exercises the conversion privilege upon the terms and conditions set forth in the attached Debenture, to the extent of the maximum number of shares of Common Stock issuable pursuant to the terms of Sections 4 and 5 of the Debenture, and accordingly, authorizes the Company to apply $__________ principal amount of the attached Debenture to payment in full for such shares of Common Stock. Please register such shares and make delivery thereof as follows: Registered in the Name of (Giving First or Middle Name in Full) Name (Please Print) Address DELIVERY INSTRUCTIONS To be completed ONLY if Certificates are to be mailed to persons other than the Registered Holder. Name (Please Print) Address Signature ny-221336 41 ASSIGNMENT FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfer unto ___________________ ____________________________________ the within Debenture and all rights thereunder, hereby irrevocably authorizing the Company to transfer said Debenture on the books of the Company, with full power of substitution in the premises. Dated: Signature:
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CONVERSION FORM. TO: Digital Ecosystems Corp. (Company) The undersigned Holder of a Loan in the amount of One Hundred Thousand Dollars in US funds (US$100,000) hereby irrevocably elects to convert the said Loan (or $ ______________ principal thereof) into common shares in accordance with the Terms and Conditions of the Loan Agreement and directs that the shares issuable and deliverable upon the conversion be issued and delivered to the address indicated below. Dated: (Signature of Holder) (Name of Holder) (Address of Holder)
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CONVERSION FORM. TO BioNeutral Group, Inc. 000 Xxxxxx Xx. Newark, New Jersey 07103 The undersigned, hereby irrevocably elects to convert the Accrued Compensation of this Agreement at a conversion price of $0.003 per share. The undersigned hereby agrees that upon conversion, the entire principal due on this Convertible Agreement shall be deemed fully paid and the Convertible Agreement will be cancelled in full. The Company shall have no obligation with respect to any principal payments after the Effective Date. Instructions for Registration of Stock NAME: _______________________________________________________________________ ADDRESS: ___________________________________________________________________ TELEPHONE: ________________________________________________________________ EMAIL: ___________________________________________________________________ AMOUNT TO BE CONVERTED $_________________________________________ DATED: ___________________________________________________________________ PRINT NAME SIGNATURE CONVERSION FORM TO BioNeutral Group, Inc. 000 Xxxxxx Xx. Newark, New Jersey 07103 The undersigned, hereby irrevocably elects to convert the Future Compensation of this Agreement at a conversion price of $_________ per share. The undersigned hereby agrees that upon conversion, the entire principal due on this Convertible Agreement shall be deemed fully paid and the Convertible Agreement will be cancelled in full. The Company shall have no obligation with respect to any principal payments after the Effective Date. Instructions for Registration of Stock NAME: _______________________________________________________________________ ADDRESS: ___________________________________________________________________ TELEPHONE: ________________________________________________________________ EMAIL: ___________________________________________________________________ AMOUNT TO BE CONVERTED $_________________________________________ DATED: ___________________________________________________________________ PRINT NAME SIGNATURE Exhibit A GENERAL SECURITY AGREEMENT THIS AGREEMENT made as of July 10, 2013 between BioNeutral Group, Inc. (“the Company”) and Xxxxxx Xxxxxxxxx (the “Secured Party”). WHERAS:
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CONVERSION FORM. TO: Digital Ecosystems Corp. (Company) The undersigned Holder of a Loan in the amount of One Hundred Thousand Dollars in US funds (US$100,000) hereby irrevocably elects to convert the said Loan (or $ ______________ principal thereof) into common shares in accordance with the Terms and Conditions of the Loan Agreement and directs that the shares issuable and deliverable upon the conversion be issued and delivered to the address indicated below. Dated: __________________________________________________ __________________________________________________ (Signature of Holder) ________________________________________________________ (Name of Holder) ________________________________________________________ (Address of Holder) ________________________________________________________
Sample 1
CONVERSION FORM. If you, the Holder, want to convert this Debenture, complete the form below. I, the undersigned, convert $________ of principal amount of the enclosed Debenture in accordance with its terms and request that the underlying securities are issued as follows: Holder's name: _________________________________ Address: _________________________________ Tax ID: __________________ and irrevocably appoint _____________________________, agent to transfer this Debenture on the books of the Company. Dated: _____________ BY_______________________________________ Signature of holder _______________________________________ Printed name
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Related to CONVERSION FORM

  • Form of Conversion Notice Each convertible Security shall have attached thereto, or set forth on the reverse of the Security, a notice of conversion in substantially the following form: Conversion Notice To: Xxxxxxxx Offshore Services, Inc. The undersigned owner of this Security hereby: (i) irrevocably exercises the option to convert this Security, or the portion hereof below designated, for shares of Common Stock of Xxxxxxxx Offshore Services, Inc. in accordance with the terms of the Indenture referred to in this Security and (ii) directs that such shares of Common Stock deliverable upon the conversion, together with any check in payment for fractional shares and any Security(ies) representing any unconverted principal amount hereof, be issued and delivered to the registered holder hereof unless a different name has been indicated below. If shares are to be delivered registered in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any amount required to be paid by the undersigned on account of interest accompanies this Security. Dated: Signature: Fill in for registration of shares if to be delivered, and of Securities if to be issued, otherwise than to and in the name of the registered holder. (Name) Social Security or other Taxpayer Identification Number (Please print name and address) Principal amount to be converted: (if less than all) $ . Signature Guarantee* * Participant in a recognized Signature Guarantee Medallion Program (or other signature acceptable to the Trustee).

  • CONVERSION NOTICE The undersigned holder of this Debenture hereby irrevocably converts the Debenture, or any portion of the principal amount at Maturity hereof (which is an integral multiple of US $1,000) below designated, into Common Shares of the Company in accordance with the terms of this Debenture, and directs that such shares, together with a Cheque in payment for any fractional shares and any Debentures representing any unconverted principal amount hereof, be delivered to and be registered in the name of the undersigned unless a different name has been indicated below. If Common Shares or Debentures are to be registered in the name of a Person other than the undersigned (which other Person the undersigned acknowledges may only be an affiliate of the undersigned), the undersigned will pay all transfer taxes, if any, payable with respect thereto. Dated: ---------------------- ----------------------------------------- ----------------------------------------- Signature(s) If Common Shares or Debentures are to be registered in If only a portion of the Debenture is to be converted, the name of a Person other than the Holder, please indicate: print such Person's name and address: ------------------------------------- Principal amount to be converted: Name US$ -------------------------------- (US$1,000 denomination or ------------------------------------- integral multiple thereof) Address ------------------------------------- Taxpayer Identification Number, if any The Debenture, if surrendered for conversion (in whole or in part) other than on an Interest Payment Date, shall be entitled to, and the Company shall make, a payment of interest, calculated in the normal course, on the outstanding principal for that portion of the period during which such principal was not converted on the next succeeding Interest Payment Date. For greater certainty, the principal amount of the Debenture that is converted shall be entitled to interest up to the Conversion Date, such interest to be paid on the next succeeding Interest Payment Date, together with interest on that portion of the principal that was not converted. The Company's delivery to the Holder of the number of Common Shares (and cash in lieu of fractions thereof) into which the Debenture is convertible will be deemed to satisfy the Company's obligation to pay the principal amount of the Debenture. The Holder shall promptly deliver to the Company and the Company, in turn, to the transfer agent of the Common Shares, notification of such Notice of Conversion at the address described in Section 105 The Debenture shall be deemed to have been converted immediately prior to the close of business on the Business Day of surrender of the Debenture for conversion (the "Conversion Date") in accordance with the foregoing provisions, and at such time the rights of the Holder, as holder of the principal amount of the Debenture so converted, shall cease, and the Person or Persons entitled to receive the Common Shares issuable upon conversion shall be treated for all purposes as the record holder or holders of such Common Shares at such time. As promptly as practicable on or after the Conversion Date, the Company shall issue and deliver to the Holder, a certificate or certificates for the number of full shares of Common Shares issuable upon conversion, together with payment in lieu of any fraction of a share, as provided in Section 1208. If the Debenture is converted in part only, upon such conversion the Company shall execute and deliver to the Holder, at the expense of the Company, a new Debenture or Debentures of authorized denominations in an aggregate principal amount equal to the unconverted portion of the principal amount of such Debenture. The Debenture may be converted in part, but only if the principal amount to be converted is any integral multiple of US$1,000.

  • Notice of Conversion/Continuation a Notice of Conversion/Continuation to be provided by Borrower Agent to request a conversion or continuation of any Loans as LIBOR Loans, in form satisfactory to Agent.

  • Continuation and Conversion Elections By delivering a Continuation/Conversion Notice to the Administrative Agent on or before 12:00 noon, New York City time, on a Business Day, the Borrower may from time to time irrevocably elect, on not less than one Business Day's notice (in the case of a conversion of LIBO Rate Loans to Base Rate Loans) or three Business Days' notice (in the case of a continuation of LIBO Rate Loans or a conversion of Base Rate Loans into LIBO Rate Loans) nor more than five Business Days' notice (in the case of any Loans) that all, or any portion (a) in a minimum amount of $1,000,000 or any larger integral multiple of $500,000, be, in the case of Base Rate Loans, converted into LIBO Rate Loans or, in the case of LIBO Rate Loans, continued as LIBO Rate Loans or (b) in a minimum amount of $500,000 or any larger integral multiple of $100,000, be, in the case of LIBO Rate Loans, converted into Base Rate Loans (in the absence of delivery of a Continuation/Conversion Notice with respect to any LIBO Rate Loan at least three Business Days before the last day of the then current Interest Period with respect thereto, such LIBO Rate Loan shall, on such last day, automatically convert to a Base Rate Loan); provided, however, that (x) each such conversion or continuation shall be pro rated among the applicable outstanding Loans of the relevant Lenders, and (y) no portion of the outstanding principal amount of any Loans may be continued as, or be converted into, LIBO Rate Loans when any Default or Event of Default has occurred and is continuing.

  • Conversion and Continuation Elections (a) The Borrower may, upon irrevocable written notice to the Agent in accordance with this Section 2.5:

  • Automatic Conversion Upon the automatic conversion of all outstanding shares of the series of equity securities comprising the Exercise Shares, this Warrant shall become exercisable for that number of shares of Common Stock of the Company into which the Exercise Shares would then be convertible, so long as such shares, if this Warrant had been exercised prior to such offering, would have been converted into shares of the Company’s Common Stock pursuant to the Company’s Certificate of Incorporation. In such case, all references to “Exercise Shares” shall mean shares of the Company’s Common Stock issuable upon exercise of this Warrant, as appropriate.

  • Mandatory Conversion Provided an Event of Default has not occurred, then, commencing after the Actual Effective Date, the Borrower will have the option by written notice to the Holder ("Notice of Mandatory Conversion") of compelling the Holder to convert all or a portion of the outstanding and unpaid principal of the Note and accrued interest, thereon, into Common Stock at the Conversion Price then in affect ("Mandatory Conversion"). The Notice of Mandatory Conversion, which notice must be given on the first day following a consecutive seven (7) day trading period during which the closing bid price for the Company's Common Stock as reported by Bloomberg, LP for the Principal Market shall be more than $3.00 each day with an average daily trading volume of 80,000 shares. The date the Notice of Mandatory Conversion is given is the "Mandatory Conversion Date." The Notice of Mandatory Conversion shall specify the aggregate principal amount of the Note which is subject to Mandatory Conversion, which amount may not exceed in the aggregate, for all Holders who received Notes similar in term and tenure as this Note, the dollar volume of Common Stock traded on the Principal Market during the seven (7) trading days immediately preceding the Mandatory Conversion Date. Mandatory Conversion Notices must be given proportionately to all Holders of Notes who received Notes similar in term and tenure as this Note. The Borrower shall reduce the amount of Note principal and interest subject to a Notice of Mandatory Conversion by the amount of Note Principal and interest for which the Holder had delivered a Notice of Conversion to the Borrower during the twenty (20) trading days preceding the Mandatory Conversion Date. Each Mandatory Conversion Date shall be a deemed Conversion Date and the Borrower will be required to deliver the Common Stock issuable pursuant to a Mandatory Conversion Notice in the same manner and time period as described in Section 2.2 above.

  • Optional Conversion To convert any Conversion Amount into shares of Common Stock on any date (a "Conversion Date"), the Holder shall (A) transmit by email, facsimile (or otherwise deliver), for receipt on or prior to 11:59 p.m., New York, NY Time, on such date, a copy of an executed notice of conversion in the form attached hereto as Exhibit A (the "Conversion Notice") to the Company. On or before the third Business Day following the date of receipt of a Conversion Notice (the "Share Delivery Date"), the Company shall (A) if legends are not required to be placed on certificates of Common Stock pursuant to the then existing provisions of Rule 144 of the Securities Act of 1933 (“Rule 144”) and provided that the Transfer Agent is participating in the Depository Trust Company's ("DTC") Fast Automated Securities Transfer Program, credit such aggregate number of shares of Common Stock to which the Holder shall be entitled to the Holder's or its designee's balance account with DTC through its Deposit Withdrawal Agent Commission system or (B) if the Transfer Agent is not participating in the DTC Fast Automated Securities Transfer Program, issue and deliver to the address as specified in the Conversion Notice, a certificate, registered in the name of the Holder or its designee, for the number of shares of Common Stock to which the Holder shall be entitled which certificates shall not bear any restrictive legends unless required pursuant the Rule 144. If this Note is physically surrendered for conversion and the outstanding Principal of this Note is greater than the Principal portion of the Conversion Amount being converted, then the Company shall, upon request of the Holder, as soon as practicable and in no event later than three (3) Business Days after receipt of this Note and at its own expense, issue and deliver to the holder a new Note representing the outstanding Principal not converted. The Person or Persons entitled to receive the shares of Common Stock issuable upon a conversion of this Note shall be treated for all purposes as the record holder or holders of such shares of Common Stock upon the transmission of a Conversion Notice.

  • Method of Conversion This Note may be converted by the Holder in whole or in part as described in Section 2.1(a) hereof and the Subscription Agreement. Upon partial conversion of this Note, a new Note containing the same date and provisions of this Note shall, at the request of the Holder, be issued by the Borrower to the Holder for the principal balance of this Note and interest which shall not have been converted or paid.

  • Data Conversion [insert City or Contractor] shall be responsible for the timely and accurate conversion of City’s data to the format required by the Programs [or, System], and for providing the test data specified in the Acceptance Test Plan [or, Design Specifications].

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