Dated. Signed: ------------------------ ------------------------------------ (Sign exactly as name appears on the other side of this Note) Signature Guarantee: --------------------------------------------------------- Participants in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------
Appears in 1 contract
Samples: Garden State Newspapers Inc
Dated. Signed: ------------------------ ------------------------------------ -------------------------- --------------------------------- (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants ------------------------------------------------------------ Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) TO BE COMPLETED BY PURCHASER IF (2a) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note Security for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- --------------------- ------------------------------------ NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Security purchased by the Company pursuant to Sections 4.16 or 4.17 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Call Points Inc
Dated. Signed: ------------------------ ------------------------------------ ------------------ ------------------------------------------ (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) ----------------------------------------------------------- TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration requirements of the Securities Act provided by Rule 144A. 144A thereunder. Dated: ----------------------------- --------------------------------------- NOTICE------------------ --------------------------------------------- Executive Officer Name: To be executed _______________________ Title: _______________________ FORM OF OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Note purchased by an executive officer Signature Guarantee: ---------------------------------------------------------the Company pursuant to Section 4.14 or Section 4.15 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Article Twelve (Discovery Zone Inc)
Dated. Signed: ------------------------ ------------------------------------ ------------------- -------------------------------------------- (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) ----------------------------------------------------------- TO BE COMPLETED BY PURCHASER IF BOX (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- --------------------------- ------------------------------------ NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------[OPTION OF HOLDER TO ELECT PURCHASE] If you want to elect to have this Note purchased by the Company pursuant to Section 4.15 or Section 4.16 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Hutchinson Products Corp
Dated. Signed: ------------------------ ------------------------------------ ---------------------- ------------------------------------------ (Sign exactly as name appears on the other side of this Note) Signature Guarantee: --------------------------------------------------------- Participants in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, amended and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- ------------------ -------------------------------------------- NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------[OPTION OF HOLDER TO ELECT PURCHASE] If you want to elect to have this Note purchased by the Company pursuant to Section 4.14 or Section 4.15 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Indenture (Penn National Gaming Inc)
Dated. Signed: ------------------------ ------------------------------------ ----------- --------------------------------------------- (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants ---------------------------------------------------------- Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the TrusteeRegistrar) TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration requirements of the Securities Act provided by Rule 144A. 144A thereunder. Dated: ----------------------------- --------------------------------------- NOTICE--------------- -------------------------------------------------- Executive Officer Name: To be executed _______________________ Title: ______________________ FORM OF OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Note purchased by an executive officer Signature Guarantee: ---------------------------------------------------------the Company pursuant to Section 4.14 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Registration Rights Agreement (New World Coffee Manhattan Bagel Inc)
Dated. Signed: ------------------------ ------------------------------------ Signed:----------------------------------------- (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants Guarantee:------------------------------------------------------ Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the TrusteeRegistrar) TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration requirements of the Securities Act provided by Rule 144A. 144A thereunder. Dated: ----------------------------- --------------------------------------- NOTICEExecutive Officer Name: To be executed _______________________ Title: _______________________ FORM OF OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Note purchased by an executive officer Signature Guarantee: ---------------------------------------------------------the Company pursuant to Section 4.14 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Registration Rights Agreement (New World Coffee Manhattan Bagel Inc)
Dated. Signed: ------------------------ ------------------------------------ ---------------------------- ----------------------------- (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) ----------------------------------------------------------- TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note Security for its own account or an account with respect to which it if exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- ------------------------------------- NOTICE: To be executed by an executive officer Signature GuaranteeOPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Security purchased by the Company pursuant to Section 4.9 or Section 4.19 of the Indenture, check the appropriate box below: ---------------------------------------------------------[_] Section 4.9 (Change in Control) [_] Section 4.19 (Asset Sale) If you want to elect to have only part of the Security purchased by the Company pursuant to Section 4.9 or Section 4.19, state the amount you elect to have purchased: $_________ Date: Your Signature: ---------- ------------------------------ (Sign exactly as your name appears on the face of this Security)
Appears in 1 contract
Samples: SFW Holding Corp
Dated. Signed: ------------------------ ------------------------------------ --------- ------------------------------------------ (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants ---------------------------------------------------------- Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the TrusteeRegistrar) TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration requirements of the Securities Act provided by Rule 144A. 144A thereunder. Dated: ----------------------------- --------------------------------------- NOTICE--------------- ------------------------------------------------ Executive Officer Name: To be executed ________________________ Title: ________________________ FORM OF OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Note purchased by an executive officer Signature Guarantee: ---------------------------------------------------------the Company pursuant to Section 4.14 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Registration Rights Agreement (New World Coffee Manhattan Bagel Inc)
Dated. Signed: ------------------------ ------------------------------------ ------------------- -------------------------------- (Sign exactly as name appears on the other side of this Note) Signature Guarantee: --------------------------------------------------------- Participants ----------------------------------------------------------- Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company Issuers as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- ------------------- --------------------------------------- NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Note purchased by the Issuers pursuant to Section 4.09 or Section 4.13 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Norcraft Companies Lp
Dated. Signed: ------------------------ ------------------------------------ ------------------ ----------------------------------------- (Sign exactly as your name appears on the other side of this Note) Signature Guarantee: --------------------------------------------------------- Participants in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) TO BE COMPLETED BY PURCHASER IF BOX (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- ------------------------------------ NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------[OPTION OF HOLDER TO ELECT PURCHASE] If you want to elect to have this Note purchased by the Company pursuant to Section 4.15 or Section 4.16 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Hutchinson Products Corp
Dated. Signed: ------------------------ ------------------------------------ ------------------------------ -------------------------------- (Sign exactly as name appears on the other side of this Note) Signature Guarantee: --------------------------------------------------------- Participants -------------------------------------- Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company Issuers as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- ------------------------------ ---------------------------------------- NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Note purchased by the Issuers pursuant to Section 4.09, Section 4.13 or Section 4.17 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Stanley-Martin Communities, LLC
Dated. Signed: ------------------------ ------------------------------------ ------------------ -------------------------------------------- (Sign exactly as your name appears on the other side of this Note) Signature Guarantee: --------------------------------------------------------- Participants ------------------------------------------------------------ Signatures must be guaranteed by an "eligible guarantor institution" meeting the requirements of the Registrar, which requirements on and after October 26, 1992 will include membership or participation in a recognized Signature Guarantee Medallion Program (STAMP or such other "signature guarantor program reasonably acceptable to guarantee program" as may be determined by the Trustee) Registrar in addition to, or in substitution for, STAMP, all in accordance with the Securities Exchange Act of 1934, as amended. TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, amended and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company Issuer as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration provided by Rule 144A. Dated: ----------------------------- --------------------------------------- ------------------- -------------------------------------------------- NOTICE: To be executed by an executive officer Signature Guarantee: ---------------------------------------------------------[OPTION OF HOLDER TO ELECT PURCHASE] If you want to elect to have this Note purchased by the Issuer pursuant to Section 4.11 or Section 4.12 of this Indenture, check the appropriate box:
Appears in 1 contract
Samples: Mobile Field Office Co
Dated. Signed: ------------------------ ------------------------------------ ------------------ ------------------------------------------ (Sign exactly as name appears on the other side of this NoteSecurity) Signature Guarantee: --------------------------------------------------------- Participants in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably acceptable to the Trustee) ----------------------------------------------------------- TO BE COMPLETED BY PURCHASER IF (2) ABOVE IS CHECKED The undersigned represents and warrants that it is purchasing this Note for its own account or an account with respect to which it exercises sole investment discretion and that it and any such account is a "qualified institutional buyer" within the meaning of Rule 144A under the Securities Act of 1933, as amended, and is aware that the sale to it is being made in reliance on Rule 144A and acknowledges that it has received such information regarding the Company as the undersigned has requested pursuant to Rule 144A or has determined not to request such information and that it is aware that the transferor is relying upon the undersigned's foregoing representations in order to claim the exemption from registration requirements of the Securities Act provided by Rule 144A. 144A thereunder. Dated: ----------------------------- --------------------------------------- NOTICE------------------ --------------------------------------------- Executive Officer Name: To be executed ________________________ Title: ________________________ FORM OF OPTION OF HOLDER TO ELECT PURCHASE If you want to elect to have this Note purchased by an executive officer Signature Guarantee: ---------------------------------------------------------the Company pursuant to Section 4.14 or Section 4.15 of the Indenture, check the appropriate box:
Appears in 1 contract
Samples: Article Twelve (Discovery Zone Inc)