Check Box if Applicable. In lieu of receiving the shares of Common Stock issuable pursuant to this Notice of Exercise by way of DTC Transfer, the undersigned hereby requests that the Corporation issue and deliver to the undersigned physical certificates representing such shares of Common Stock.
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Samples: Warrant Agreement (Robotic Vision Systems Inc), Warrant Agreement (Fastcomm Communications Corp), Warrant Agreement (Robotic Vision Systems Inc)
Check Box if Applicable. [ ] In lieu of receiving the shares of Common Stock issuable pursuant to this Notice of Exercise by way of DTC Transfer, the undersigned hereby requests that the Corporation issue and deliver to the undersigned physical certificates representing such shares of Common Stock.
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