Designated to Confirm Funds Transfer Instructions. Escrow Agent: Name Telephone Number
Designated to Confirm Funds Transfer Instructions. If to Issuer: Name Telephone Number
Designated to Confirm Funds Transfer Instructions. If to Buyer: Name Telephone Number
Designated to Confirm Funds Transfer Instructions. If from Party A: Name Telephone Number
Designated to Confirm Funds Transfer Instructions. If to the Placement Agents: Name Telephone Number Xxxxxxx Xxxxx (000) 000-0000 If to the Company (for the Company or the Selling Stockholders): Name Telephone Number Xxxxx X. Xxxxxxxxxx (000) 000-0000 Telephone call-backs shall be made to the Placement Agents and the Company if joint instructions are required pursuant to this Escrow Agreement. EXHIBIT D [Form of Subscription Termination Notice] April __, 2013 American Stock Transfer & Trust Company, LLC 0000 00xx Xxxxxx Xxxxxxxx, Xxx Xxxx 00000 Attention: Corporate Actions Dear: Pursuant to the Escrow Agreement dated as of April [ ], 2013 (the “Escrow Agreement”) by and among Xxxxxx-Xxxxx, Inc. (the “Company”), XX Xxxxxxxxx + Co, LLC, the selling stockholders party thereto and American Stock Transfer & Trust Company, LLC, the Company and the Selling Stockholders hereby notifiy you that the following subscription(s) have been rejected: Name of Subscriber Amount of Subscribed Shares [Units] Rejected Dollar Amount of Rejected Subscription XXXXXX-XXXXX, INC. By: Name: Xxxxxxx X. Xxxxx Title: President and Chief Executive Officer SELLING STOCKHOLDERS: THE XXXXX FAMILY REVOCABLE TRUST dated August 1, 2004 By: Xxxxxxx X. Xxxxx, Co-Trustee By: Xxxxxx X. Xxxxx, Co-Trustee THE XXXXX 2005 FAMILY TRUST U/T/D dated August 24, 2005 By: Xxxxx X. Xxxxx, Trustee THE XXXXX 2003 FAMILY TRUST U/T/A dated June 5, 2003 By: Xxxx X. Xxxxx, III, Trustee Xxxxxxxx Xxxxx Xxxxxxx Xxxx Xx Xxxxxxxxxx Xxxxxxxxx X. Xxxxxxxxx Xxxx-Xxxxx X. Xxxxxxxxx
Designated to Confirm Funds Transfer Instructions. If to the Managing Owner: Name Telephone Number
Designated to Confirm Funds Transfer Instructions. If to the Company: Name Telephone Number
Designated to Confirm Funds Transfer Instructions. If to the Underwriters: Name Telephone Number [ ] [ ] If to the Company: Name Telephone Number [ ] [ ] Telephone call-backs shall be made to the Underwriters and the Company if joint instructions are required pursuant to this Escrow Agreement. EXHIBIT D [Form of Subscription Termination Notice] March , 2015 American Stock Transfer & Trust Company, LLC 0000 00xx Xxxxxx Xxxxxxxx, Xxx Xxxx 00000 Attention: Corporate Actions Dear: Pursuant to the Escrow Agreement dated as of March [ ], 2015 (the “Escrow Agreement”) by and among XBiotech, Inc. (the “Company”), XX Xxxxxxxxx + Co, LLC and American Stock Transfer & Trust Company, LLC, the Company hereby notifies you that the following subscription(s) have been rejected: Name of Subscriber Amount of Subscribed Shares [Units] Rejected Dollar Amount of Rejected Subscription XBIOTECH, INC. By: Name: Xxxx Xxxxxx Title: President and Chief Executive Officer
Designated to Confirm Funds Transfer Instructions and Execute Instructions, and Other Documents in Connection with this Escrow Agreement (Acquisitions) If to Seller: Name Telephone Number Signature Identification
Designated to Confirm Funds Transfer Instructions. If to Parent: Name Telephone Number
