Common use of To the Rights Agent Clause in Contracts

To the Rights Agent. The undersigned hereby irrevocably elects to exercise Rights represented by this Right Certificate to purchase the Preferred Shares, Common Shares or such other securities issuable upon the exercise of such Rights at this time as follows: Please Insert Number of Rights To Be Exercised (i) Preferred Shares Exercise _______________ (ii) Section 11(a)(ii) Exercise _______________ (iii) Section 13 Exercise _______________ The undersigned requests that certificates for such Preferred Shares, Common Shares or other securities be issued in the name of: Please insert social security or other identifying number ________________________________ ____________________________________________________________ (Please print name and address of transferee) ____________________________________________________________ If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ________________________________ ____________________________________________________________ (Please print name and address of transferee) ____________________________________________________________ Dated: _________, 19__ ____________________ Signature Signature Guaranteed: Signatures must be guaranteed by a member firm of a registered national securities exchange, a member of the National Association of Securities Dealers, Inc., or a commercial bank, savings association, credit union or trust company having an office or correspondent in the United States or other eligible guarantor institution which is a participant in a signature guarantee medallion program.

Appears in 2 contracts

Samples: Rights Agreement Rights Agreement (Family Bargain Corp), Rights Agreement Rights Agreement (Family Bargain Corp)

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To the Rights Agent. The undersigned hereby irrevocably elects to exercise Rights represented by this Right Certificate to purchase the Preferred Shares, Common Shares or such other securities issuable upon the exercise of such Rights at this time as follows: Please Insert Number of Rights To Be Exercised (i) Preferred Shares Exercise _______________ (ii) Section 11(a)(ii) Exercise _______________ (iii) Section 13 Exercise _______________ The undersigned requests that certificates for such Preferred Shares, Common Shares or other securities be issued in the name of: Please insert social security or other identifying number ________________________________ ____________________________________________________________ Rights represented by this Right Certificate to purchase the Preferred Shares, Common Shares or other securities issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares, Common Shares or other securities be issued in the name of: Please insert social security or other identifying number ----------------------------------------------------------------------- (Please print name and address of transfereeaddress) ____________________________________________________________ ----------------------------------------------------------------------- If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ________________________________ ____________________________________________________________ ----------------------------------------------------------------------- (Please print name and address address) ----------------------------------------------------------------------- Form of transferee) ____________________________________________________________ Reverse Side of Right Certificate -- continued ------------------------------------------------------------------------------- Dated: _________---------------------------------------, 19__ ____________________ ------ ------------------------------- Signature Signature Guaranteed: Signatures must be guaranteed by a member firm of a registered national securities exchange, a member of the National Association of Securities Dealers, Inc., or a commercial bank, savings association, credit union or trust company having an office or correspondent in the United States or other eligible guarantor institution which is a participant in a signature guarantee medallion program.

Appears in 1 contract

Samples: Rights Agreement (Gleason Corp /De/)

To the Rights Agent. The undersigned hereby irrevocably elects to exercise _________________ Rights represented by this Right Certificate to purchase the Preferred Shares, Common Shares or such other securities issuable upon the exercise of such Rights at this time as follows: Please Insert Number of Rights To Be Exercised (i) Preferred Shares Exercise _______________ (ii) Section 11(a)(ii) Exercise _______________ (iii) Section 13 Exercise _______________ The undersigned and requests that certificates for such Preferred Shares, Common Shares or other securities be issued in the name of: Please insert social security or other identifying number ________________________________________________ _____________________________________________________________________________ (Please print name and address of transfereeaddress) _____________________________________________________________________________ If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ________________________________________________ _____________________________________________________________________________ (Please print name and address of transfereeaddress) _____________________________________________________________________________ Form of Reverse Side of Right Certificate -- continued -------------------------------------------------------------------------------- Dated: _______________, 19____ _______________________________ Signature Signature Guaranteed: Signatures must be guaranteed Form of Reverse Side of Right Certificate -- continued. -------------------------------------------------------------------------------- The undersigned hereby certifies that (1) the Rights evidenced by a member firm this Right Certificate are not being exercised by or on behalf of a registered national securities exchange, a member Person who is or was an Acquiring Person or an Affiliate or Associate thereof (as such terms are defined in the Rights Agreement) and (2) after due inquiry and to the best knowledge of the National Association of Securities Dealersundersigned, Inc., the undersigned did not acquire the Rights evidenced by this Rights Certificate from any Person who is or a commercial bank, savings association, credit union was an Acquiring Person or trust company having an office Affiliate or correspondent Associate thereof (as such terms are defined in the United States or other eligible guarantor institution which is a participant in a signature guarantee medallion programRights Agreement).

Appears in 1 contract

Samples: Rights Agreement (Display Technologies Inc)

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To the Rights Agent. The undersigned hereby irrevocably elects to exercise Rights represented by this Right Certificate to purchase the Preferred Shares, Common Shares or such other securities issuable upon the exercise of such Rights at this time as follows: Please Insert Number of Rights To Be Exercised (i) Preferred Shares Exercise _exercise______________ (ii) Section 11(a)(ii) Exercise _______________ (iii) Section 13 Exercise _______________ The undersigned Rights represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares, Common Shares or other securities be issued in the name of: Please insert social security or other identifying number __________________________ _____________________________________________________________________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ___________________________ ____________________________________________________________ (Please print name and address of transferee) ____________________________________________________________ If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ________________________________ ____________________________________________________________ (Please print name and address of transfereeaddress) _____________________________________________________________________________ Dated: _________, 19__________ ___________________________________ Signature Signature Guaranteed: Signatures must be guaranteed by a member firm of a registered national securities exchange, a member of the National Association of Securities Dealers, Inc., or a commercial bank, savings association, credit union bank or trust company having an office or correspondent in the United States States. Form of Reverse Side of Right Certificate -- continued -------------------------------------------------------------------------------- The undersigned hereby certifies that (i) the Rights evidenced by this Right Certificate are not beneficially owned by an Acquiring Person or other eligible guarantor institution which an Affiliate or Associate thereof (as such terms are defined in the Rights Agreement) and (ii) after due inquiry and, to the best knowledge of the undersigned, the undersigned did not acquire the Rights evidenced by this Rights Certificate from any Person who is a participant or was an Acquiring Person or an Affiliate or Associte thereof (as such terms are defined in a signature guarantee medallion programthe Rights Agreement).

Appears in 1 contract

Samples: Rights Agreement (Abc Bancorp)

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