Common use of Form of Receipt Clause in Contracts

Form of Receipt. (On the front) ANY UNITED STATES PERSON WHO HOLDS THIS OBLIGATION WILL BE SUBJECT TO LIMITATIONS UNDER THE UNITED STATES INCOME TAX LAWS, INCLUDING THE LIMITATIONS PROVIDED IN SECTIONS 165(j) AND 1287(a) OF THE INTERNAL REVENUE CODE. [BY ACCEPTING THIS OBLIGATION, THE HOLDER REPRESENTS AND WARRANTS THAT IT IS NOT A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4) OF THE INTERNAL REVENUE CODE AND REGULATIONS THEREUNDER) AND THAT IT IS NOT ACTING FOR OR ON BEHALF OF A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER).]1 PEPSICO, INC. [Specified Currency and Nominal Amount of Tranche] EURO MEDIUM TERM NOTES DUE [Year of Maturity] Series No. [ ] Receipt for the sum of [ ] being the instalment of principal payable in accordance with the Terms and Conditions endorsed on the Note to which this Receipt appertains (the Conditions) on [ ]. This Receipt is issued subject to and in accordance with the Conditions which shall be binding upon the holder of this Receipt (whether or not it is for the time being attached to such Note) and is payable at the specified office of the Agent or any of the Paying Agents set out on the reverse of the Note to which this Receipt appertains (and/or any other or further Paying Agents and/or specified offices as may from time to time be duly appointed and notified to the Noteholders). This Receipt must be presented for payment together with the Note to which it appertains. The Issuer shall have no obligation in respect of any Receipt presented without the Note to which it appertains or any unmatured Receipts. PEPSICO, INC. By: Authorised Signatory ____________________________________________________________________________________________________________ 1 This legend will be required for all Notes with maturity (at issue) of 183 days or less.

Appears in 2 contracts

Samples: Agency Agreement (Pepsico Inc), Agency Agreement (Pepsico Inc)

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Form of Receipt. (On the frontnot applicable for K-type and CF-type Notes) [ANY UNITED STATES PERSON WHO HOLDS THIS OBLIGATION WILL BE SUBJECT TO LIMITATIONS UNDER THE UNITED STATES INCOME TAX LAWS, INCLUDING THE LIMITATIONS PROVIDED IN SECTIONS 165(j) AND 1287(a) OF THE INTERNAL REVENUE CODE. CODE OF 1986.] 1 [BY ACCEPTING THIS OBLIGATION, THE HOLDER REPRESENTS AND WARRANTS THAT IT IS NOT A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(46049(B)(4) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER) AND THAT IT IS NOT ACTING FOR OR ON BEHALF OF A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(46049(B)(4) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER).]1 PEPSICOTHEREUNDER).] 2 [NAME OF ISSUER] [(having its corporate seat in Zaandam, INC. The Netherlands)]3 [Specified Currency and Nominal Amount Title of Tranche] EURO MEDIUM TERM NOTES DUE [Year of Maturity] Series No. [ Issue] Receipt for the sum of [ ] being the instalment of principal payable in accordance with the Terms and Conditions endorsed on the Note to which this Receipt appertains (the Conditions) on [ ]. This Receipt is issued subject to and in accordance with the Conditions which shall be binding upon the holder of this Receipt (whether or not it is for the time being attached to such Note) and is payable at the specified office of the Agent or any of the Paying Agents set out on the reverse of the Note to which this Receipt appertains (and/or any other or further Paying Agents and/or specified offices as may from time to time be duly appointed and notified to the Noteholders). This Receipt must be presented for payment together with the Note to which it appertains. The Issuer shall have no obligation in respect of any Receipt presented without the Note to which it appertains or any unmatured Receipts. PEPSICO, INC. By: Authorised Signatory ____________________________________________________________________________________________________________ 1 This legend will be required for all Notes with maturity (at issue) of 183 days or less.[NAME OF ISSUER]

Appears in 1 contract

Samples: Agency Agreement (Royal Ahold)

Form of Receipt. (On the front) [Face of Receipt] [ANY UNITED STATES PERSON WHO HOLDS THIS OBLIGATION WILL BE SUBJECT TO LIMITATIONS UNDER THE UNITED STATES INCOME TAX LAWS, INCLUDING THE LIMITATIONS PROVIDED IN SECTIONS 165(j) AND 1287(a) OF THE INTERNAL REVENUE CODE. .] 1 [BY ACCEPTING THIS OBLIGATION, THE HOLDER REPRESENTS AND WARRANTS THAT IT IS NOT A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER) AND THAT IT IS NOT ACTING FOR OR ON BEHALF OF A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER).]1 PEPSICO, INC. THEREUNDER).] 2 INTERNATIONAL LEASE FINANCE CORPORATION [Specified Currency and Nominal Amount of Tranche] EURO MEDIUM TERM NOTES DUE [Year of Maturity] Notes Series No. [ ] Receipt for the sum of [ ] being the instalment of principal payable in accordance with the Terms and Conditions endorsed on the Note to which this Receipt appertains (the Conditions) on [ ]. This Receipt is issued subject to and in accordance with the Conditions which shall be binding upon the holder of this Receipt (whether or not it is for the time being attached to such Note) and is payable at the specified office of the Agent or any of the Paying Agents set out on the reverse of the Note to which this Receipt appertains (and/or any other or further Paying Agents and/or specified offices as may from time to time be duly appointed and notified to the Noteholders). This Receipt must be presented for payment together with the Note to which it appertains. The Issuer shall have no obligation in respect of any Receipt presented without the Note to which it appertains or any unmatured Receipts. PEPSICO, INC. By: Authorised Signatory ____________________________________________________________________________________________________________ 1 This legend will be required for all Notes with maturity (at issue) of 183 days or less.

Appears in 1 contract

Samples: Agency Agreement (International Lease Finance Corp)

Form of Receipt. (On the front) ANY UNITED STATES PERSON (AS DEFINED IN THE INTERNAL REVENUE CODE OF THE UNITED STATES) WHO HOLDS THIS OBLIGATION WILL BE SUBJECT TO LIMITATIONS UNDER THE UNITED STATES INCOME TAX LAWS, LAWS INCLUDING THE LIMITATIONS PROVIDED IN SECTIONS 165(j) AND 1287(a) OF THE INTERNAL REVENUE CODE. [BY ACCEPTING THIS OBLIGATIONCODE.3 TOYOTA MOTOR CREDIT CORPORATION (Incorporated under the laws of the State of California, THE HOLDER REPRESENTS AND WARRANTS THAT IT IS NOT A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4U.S.A.) OF THE INTERNAL REVENUE CODE AND REGULATIONS THEREUNDER) AND THAT IT IS NOT ACTING FOR OR ON BEHALF OF A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER).]1 PEPSICO, INC. [Specified Currency and Nominal Amount of TrancheSeries] EURO MEDIUM MEDIUM-TERM NOTES DUE [Year of Maturity] Series No. [ ] Receipt for the sum of [ ] being the instalment installment of principal payable in accordance with the Terms and Conditions endorsed on the Note to which this Receipt appertains (the Conditions) on [ ]. This Receipt is issued subject to and in accordance with the Conditions which shall be binding upon the holder of this Receipt (whether or not it is for the time being attached to such Note) and is payable at the specified office of the Agent or any of the Paying Agents set out on the reverse of the Note to which this Receipt appertains (and/or any other or further Paying Agents and/or specified offices as may from time to time be duly appointed and notified to the Noteholders). This Receipt must be presented for payment together with the Note to which it appertains. The Issuer Company shall have no obligation in respect of any Receipt presented without the Note to which it appertains or any unmatured Receipts. PEPSICO, INC. [SEAL] ATTEST: TOYOTA MOTOR CREDIT CORPORATION By: Authorised Signatory Authorized Officer By: Authorized Officer 3 Use this legend in the case of Notes with a maturity of more than 183 days. In the case of Notes with a maturity of 183 days or less, the following legend should be used: By accepting this obligation, the holder represents and warrants that it is not a United States person (other than an exempt recipient described in Section 6049(b)(4) of the Internal Revenue Code and the regulations thereunder) and that it is not acting for or on behalf of a United States person (other than an exempt recipient described in Section 6049(b)(4) of the Internal Revenue Code and the regulations thereunder). XXXXXXXX X-0 FORM OF TALON (On the front) ANY UNITED STATES PERSON (AS DEFINED IN THE INTERNAL REVENUE CODE OF THE UNITED STATES) WHO HOLDS THIS OBLIGATION WILL BE SUBJECT TO LIMITATIONS UNDER THE UNITED STATES TAX LAWS INCLUDING THE LIMITATIONS PROVIDED IN SECTIONS 165(j) AND 1287(a) OF THE INTERNAL REVENUE CODE. TOYOTA MOTOR CREDIT CORPORATION (Incorporated under the laws of the State of California, U.S.A.) [Specified Currency and Nominal Amount of Series] EURO MEDIUM-TERM NOTES DUE [Year of Maturity] Series No. [ ] On and after [ ] further Coupons [and a further Talon] appertaining to the Note to which this Talon appertains will be issued at the specified office of any of the Paying Agents set out on the reverse hereof (and/or any other or further Paying Agents and/or specified offices as may from time to time be duly appointed notified to the Noteholders) upon production and surrender of this Talon. This Talon may, in certain circumstances, become void under the Terms and Conditions endorsed on the Notes to which this Talon appertains. [SEAL] ATTEST: TOYOTA MOTOR CREDIT CORPORATION By: Authorized Officer By: Authorized Officer (Reverse of Talon) ISSUING AND PRINCIPAL PAYING AGENT JPMorgan Chase Bank, N.A. Txxxxxx Xxxxx 0 Xxxxxx Xxxx Street London E1W 1YT PAYING AGENT J.X. Xxxxxx Bank Luxembourg S.A. 6 xxxxx xx Xxxxxx X-2633 Senningerberg (Municipality of Niederanven) Luxembourg and/or such other or further Agent and other or further Paying Agents and/or specified offices as may from time to time be duly appointed by the Company and notice of which has been given to the Noteholders. APPENDIX C FORM OF CALCULATION AGENCY AGREEMENT Dated ____________, 20__ TOYOTA MOTOR CREDIT CORPORATION U.S. $30,000,000,000 EURO MEDIUM-TERM NOTES CALCULATION AGENCY AGREEMENT TOYOTA MOTOR CREDIT CORPORATION U.S.$30,000,000,000 EURO MEDIUM-TERM NOTE CALCULATION AGENCY AGREEMENT THIS AGREEMENT is made on ______________________________________________________________________________________________, 20__ 1 This legend will be required for all Notes with maturity (at issue) of 183 days or less.BETWEEN:

Appears in 1 contract

Samples: Agency Agreement (Toyota Motor Credit Corp)

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Form of Receipt. (On the front) ANY UNITED STATES PERSON WHO HOLDS THIS OBLIGATION WILL BE SUBJECT TO LIMITATIONS UNDER THE UNITED STATES INCOME TAX LAWSAny United States person who holds this obligation will be subject to limitations under the United States income tax laws, INCLUDING THE LIMITATIONS PROVIDED IN SECTIONS including the limitations provided in sections 165(j) AND and 1287(a) OF THE INTERNAL REVENUE CODEof the Internal Revenue Code. [BY ACCEPTING THIS OBLIGATIONBy accepting this obligation, THE HOLDER REPRESENTS AND WARRANTS THAT IT IS NOT A UNITED STATES PERSON the holder represents and warrants that it is not a United States person (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION other than an exempt recipient described in section 6049(b)(4) OF THE INTERNAL REVENUE CODE AND REGULATIONS THEREUNDERof the Internal Revenue Code and regulations thereunder) AND THAT IT IS NOT ACTING FOR OR ON BEHALF OF A UNITED STATES PERSON and that it is not acting for or on behalf of a United States person (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION other than an exempt recipient described in section 6049(b)(4) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER).]1 of the Internal Revenue Code and the regulations thereunder).]1 PEPSICO, INC. [Specified Currency and Nominal Amount of Tranche] EURO MEDIUM TERM NOTES DUE [Year of Maturity] Series No. [ ] Receipt for the sum of [ ] being the instalment of principal payable in accordance with the Terms and Conditions endorsed on the Note to which this Receipt appertains (the Conditions) on [ ]. This Receipt is issued subject to and in accordance with the Conditions which shall be binding upon the holder of this Receipt (whether or not it is for the time being attached to such Note) and is payable at the specified office of the Agent or any of the Paying Agents set out on the reverse of the Note to which this Receipt appertains (and/or any other or further Paying Agents and/or specified offices as may from time to time be duly appointed and notified to the Noteholders). This Receipt must be presented for payment together with the Note to which it appertains. The Issuer shall have no obligation in respect of any Receipt presented without the Note to which it appertains or any unmatured Receipts. PEPSICO, INC. By: Authorised Signatory ____________________________________________________________________________________________________________ 1 This legend will be required for all Notes with maturity (at issue) of 183 days or lessless (including unilateral extensions and rollovers).

Appears in 1 contract

Samples: Agency Agreement (Pepsico Inc)

Form of Receipt. (On the front) ANY UNITED STATES PERSON WHO HOLDS THIS OBLIGATION WILL BE SUBJECT TO LIMITATIONS UNDER THE UNITED STATES INCOME TAX LAWS, INCLUDING THE LIMITATIONS PROVIDED IN SECTIONS 165(j) AND 1287(a) OF THE INTERNAL REVENUE CODE. [BY ACCEPTING THIS OBLIGATION, THE HOLDER REPRESENTS AND WARRANTS THAT IT IS NOT A UNITED STATES PERSON (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4) OF THE INTERNAL REVENUE CODE AND REGULATIONS THEREUNDER) AND THAT IT IS NOT ACTING RECEIPT FOR OR ON BEHALF DEPOSITARY SHARES EACH REPRESENTING 1/1000TH OF A UNITED STATES PERSON SHARE OF 8.375% SERIES B CUMULATIVE PERPETUAL PREFERRED STOCK (OTHER THAN AN EXEMPT RECIPIENT DESCRIBED IN SECTION 6049(b)(4LIQUIDATION PREFERENCE $25,000.00 PER SHARE, OR $25.00 PER DEPOSITARY SHARE) OF THE INTERNAL REVENUE CODE AND THE REGULATIONS THEREUNDER).]1 PEPSICOAmerican Stock Transfer & Trust Company, INC. [Specified Currency and Nominal Amount LLC, as Depositary (the “Depositary”), hereby certifies that Cede & Co. is the registered owner of Tranche] EURO MEDIUM TERM NOTES DUE [Year Depositary Shares (“Depositary Shares”), each Depositary Share representing 1/1000th of Maturity] an ownership interest in a share of 8.375% Series No. [ ] Receipt for B Cumulative Perpetual Preferred Stock, liquidation preference of $25,000.00 per share (the sum “Stock”), of [ ] being XOMA Corporation, a Delaware corporation (the instalment of principal payable in accordance “Company”), on deposit with the Terms Depositary, subject to the terms and Conditions endorsed on entitled to the Note to which this Receipt appertains benefits of the Deposit Agreement dated April 9, 2021 (the Conditions) on [ ]. This Receipt is issued subject to “Deposit Agreement”), among the Company, the Depositary, and in accordance with the Conditions which shall be binding upon the holder of this Receipt (whether or not it is for the time being attached to such Note) and is payable at the specified office of the Agent or any of the Paying Agents set out on the reverse of the Note to which this Receipt appertains (and/or any other or further Paying Agents and/or specified offices as may holders from time to time be duly appointed and notified to the Noteholdersof Receipts for Depositary Shares (“Depositary Share Receipts”). By accepting this Depositary Share Receipt, the holder hereof becomes a party to and agrees to be bound by all the terms and conditions of the Deposit Agreement. This Depositary Share Receipt must shall not be presented valid or obligatory for payment together with any purpose or entitled to any benefits under the Note to which Deposit Agreement unless it appertains. The Issuer shall have no obligation been executed by the Depositary by the manual or facsimile signature of a duly authorized officer and, if a Registrar in respect of any the Depositary Share Receipt presented without (other than the Note to which it appertains or any unmatured ReceiptsDepositary) shall have been appointed, by the manual signature of a duly authorized officer of such Registrar. PEPSICODated: April 9, INC. 2021 American Stock Transfer & Trust Company, LLC, as Depositary By: Authorised Authorized Signatory Countersigned: American Stock Transfer & Trust Company, LLC, as Registrar By: Authorized Signatory [FORM OF REVERSE OF RECEIPT] The following abbreviations when used in the instructions on the face of this Receipt shall be construed as though they were written out in full according to applicable laws or regulations. TEN COM - as tenants in common UNIF GIFT MIN ACT - ___________ Custodian __________________________________________________________________________________ (Cust) (Minor) TEN ENT - as tenants by the entireties Under Uniform Gifts to Minors Act ___________________________ 1 This legend will (State) JT TEN - as joint tenants with right of survivorship and not as tenants in common Additional abbreviations may also be required for all Notes used though not in the above list. ASSIGNMENT For value received, ________________________ hereby sell(s), assign(s) and transfer(s) unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE, AS APPLICABLE PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING POSTAL ZIP CODE, OF ASSIGNEE Depositary Shares represented by the within Receipt, and does hereby irrevocably constitute and appoint __________________ as Attorney to transfer the said Depositary Shares on the books of the within named Depositary with maturity (at issue) full power of 183 days or less.substitution in the premises. Dated:

Appears in 1 contract

Samples: Deposit Agreement (XOMA Corp)

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