Print Name. Designation ...................................
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Print Name. Designation ......................................... Dated this .. day of ........................ 20..........
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Print Name. By: ------------------------------------------ Signature Title: --------------------------------------- (required for any purchaser that is a corporation, partnership, trust or other entity) EXHIBIT C AMYLIN PHARMACEUTICALS, INC. CERTIFICATE OF SUBSEQUENT SALE ChaseMellon Shareholder Services RE: Sale of Shares of Common Stock of Amylin Pharmaceuticals, Inc. (the "Company") pursuant to the Company's Prospectus dated _______________, 2000 (the "Prospectus") Dear Sir/Madam: The undersigned hereby certifies, in connection with the sale of shares of Common Stock of the Company included in the table of Selling Shareholders in the Prospectus, that the undersigned has sold the Shares pursuant to the Prospectus and in a manner described under the caption "Plan of Distribution" in the Prospectus and that such sale complies with all applicable securities laws, including, without limitation, the Prospectus delivery requirements of the Securities Act of 1933, as amended. Selling Shareholder (the beneficial owner): ----------------------------- Record Holder (e.g., if held in name of nominee): ----------------------- Restricted Stock Certificate No.(s): ------------------------------------ Number of Shares Sold: -------------------------------------------------- Date of Sale: ----------------------------------------------------------- In the event that you receive a stock certificate(s) representing more shares of Common Stock than have been sold by the undersigned, then you should return to the undersigned a newly issued certificate for such excess shares in the name of the Record Holder and BEARING A RESTRICTIVE LEGEND. Further, you should place a stop transfer on your records with regard to such certificate. Very truly yours, By: ------------------------------------- Print Name: ----------------------------- Title: ---------------------------------- Dated: -------------------
Print Name. (Instruction: Please do not fill in any blanks other than the signature line. The purpose of the assignment is to enable the Corporation to exercise its sale/purchase option set forth in the Restricted Stock Award Agreement without requiring additional signatures on the part of the Individual.)
Print Name. North Sound Legacy Fund LLC -------------------------------- By: /s/ Xxxxxx XxXxxxx -------------------------------- Name: Xxxxxx XxXxxxx -------------------------------- Title: Chief Investment Officer -------------------------------- Address: c/o North Sound Capital LLC -------------------------------- 00 Xxxxxx Xxxxxx, Xxxxx 000 -------------------------------- Xxx Xxxxxxxxx, XX 00000 -------------------------------- Telephone: 000-000-0000 -------------------------------- Facsimile: 000-000-0000 -------------------------------- SOC/EIN#: XX-XXXXXXX Number of Shares of Series D Preferred Stock Purchased 1 --- Series D-1 Warrants Purchased 2,128 ----- Series D-2 Warrants Purchased 2,128 ----- Aggregate Purchase Price $10,000 ------- OMNIBUS SIGNATURE PAGE OF AMENDMENT NO. 1 OF THE SPECTRUM PHARMACEUTICALS, INC. PREFERRED STOCK AND WARRANT PURCHASE AGREEMENT AND REGISTRATION RIGHTS AGREEMENT The undersigned hereby executes and delivers Amendment No. 1 of the Preferred Stock and Warrant Purchase Agreement and Registration Rights Agreement, to which this signature page is attached, which, together with all counterparts of the Amendment and signature pages of the other parties named in said Amendment, shall constitute one and the same document in accordance with the terms of the Amendment.
Print Name. The full name of the 1st party should be printed as clarification of his or her identity. Second Party’s Signature (11) 2nd Party’s Signature. The binding signature of the individual or Business Entity defined as the 2nd Party or Party B must be delivered. (12)
Print Name. Date: .......................................................................... Signed: .......................................................................
Print Name. Xx. Xxxxx Xxxx (xxxxx@xxx.xxx) (20) Title: Department Chair of Nursing (8) Date: 6/15/2022 | 6:08 PM EDT (21) Print Name: Xx. Xxxx X. Smith (xxxxxx@xxxxxxxxx.xxx) (22) Date: 6/15/2022 | 8:55 AM EDT (9) Signature of Xxxx of College Signature of additional authorized Agent of Agency (if desired or required by agency)
