Conversion calculations. Date pf Conversion --------------------------------------------- Applicable Conversion Price --------------------------------------------- Number of Shares --------------------------------------------- Name/Signature Address: ---------------------------------------------
Conversion calculations. Date to Effect Conversion: Number of shares of Series X1 Preferred Stock owned prior to Conversion: Number of shares of Series X1 Preferred Stock to be Converted: Number of shares of Common Stock to be Issued: Address for delivery of physical certificates: or for DWAC Delivery: DWAC Instructions: Broker no: Account no: HOLDER By: Name: Title:
Conversion calculations. Date to Effect Conversion:_____________________________________ Principal amount of unpaid Advance to be Converted: $______________________ Accrued Interest on Advance to be Converted, if any: $_________________ Conversion Price: $_______________________ Number of Conversion Shares:____________ Signature:___________________________ Print Full Legal Name:____________________________________________________ Address for Delivery of Conversion Shares:_____________________________ _____________________________________________________________________ _____________________________________________________________________ or, if eligible: DWAC Instructions:______________________________________________ Broker No:_______________________ Account No:_________________________
Conversion calculations. (a) The number of shares of Common Stock to be issued upon each conversion of this Note pursuant to this Article III shall be determined by dividing that portion of the Principal Amount and interest and fees to be converted, if any, by the then applicable Fixed Conversion Price.
Conversion calculations. Date to Effect Conversion:__________________________________________________________________________________ Number of shares of Series Y Preferred Stock owned prior to Conversion:____________________________________________ Number of shares of Series Y Preferred Stock to be Converted:_____________________________________________________ Number of shares of Common Stock to be Issued:_______________________________________________________________ Address for delivery of physical certificates:________________________________________________________________________ ___________________________________________________________________________________________________________ or for DWAC Delivery: DWAC Instructions:_______________________________________________________________________________________ Broker no:_______________________________________________________________________________________________ Account no:______________________________________________________________________________________________ HOLDER By:_____________________________________ Name: Title:
Conversion calculations. Number of shares of Series A-[●] Preferred Stock owned prior to conversion: [_____] Number of shares of Series A-[●] Preferred Stock to be converted: [_____] Number of shares of Common Stock to be issued: [_____] [HOLDER] By: Name: Title: Date: Annex A-2 Issuer Conversion Notice Battalion Oil Corporation, a Delaware corporation, hereby irrevocably elects to convert the number of shares of Series A-[●] Preferred Stock held by you indicated below into shares of Common Stock at the Conversion Ratio on the date set forth below pursuant to Section 7(b) of the Certificate of Designations. Capitalized terms utilized but not defined herein shall have the meaning ascribed to such terms in that certain Certificate of Designations of Series A-[●] Redeemable Convertible Preferred Stock, filed by Battalion Oil Corporation on [●], 202[●] (the “Certificate of Designations”).
Conversion calculations. Date to Effect Conversion ----------------------------------------------- Principal Amount of Debentures to be Converted ----------------------------------------------- Number of shares of Common Stock to be Issued ----------------------------------------------- Applicable Conversion Price ----------------------------------------------- Signature ----------------------------------------------- Name ----------------------------------------------- Address EXHIBIT B COMPANY CONVERSION NOTICE (To be Executed by the Company to Require Conversion of Debentures) The undersigned authorized officer of the Verso Technologies, Inc. (the "Company") hereby requires the conversion of the principal amount of the Company's Debentures held by the registered holder addressee hereof of the Company's Common Stock (the "Common Stock") pursuant to the conditions of the Dentures as of the date written below. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. Conversion calculations: ---------------------------------------- Date to Effect Conversion ---------------------------------------- Principal Amount of Debentures to be Converted ---------------------------------------- Number of shares of Common Stock to be Issued ---------------------------------------- Applicable Conversion Price ---------------------------------------- Signature ---------------------------------------- Name and Office In order to induce the Company to issue shares without restrictive legend, the undersigned hereby covenants and agrees that the undersigned (i) will not sell or otherwise dispose of the shares of Common Stock to be delivered pursuant to this Conversion Notice (the "Shares") except pursuant to an effective registration statement (the "Registration Statement") under the Securities Act of 1933, as amended (the "Act"), (ii) will sell the Shares only in accordance with the Plan of Distribution set forth in the prospectus forming a part of the Registration Statement (the ("Prospectus"), (iii) will comply with the requirements of the Act when selling or otherwise disposing of the Shares, including, but not limited to, the prospectus delivery requirements of the Act, (iv) will not sell or otherwise dispose of, and will return immediately to the Company for the purpose of placing a restrictive legend thereon, the
Conversion calculations. Number of shares of Series A Preferred Stock owned prior to conversion: [ ] Number of shares of Series A Preferred Stock to be converted: [ ] Number of shares of Common Stock to be issued: [ ] [HOLDER] By: Name: Title: Date: Annex B-1
Conversion calculations. Date to Effect Conversion ------------------------------------------------ Principal amount of Debenture owned prior to conversion ------------------------------------------------ Principal amount of Debenture to be Converted (including _______________ of interest added under Section 2(b) of the Debenture) --------------------------------------------------- Principal amount of Debenture remaining after Conversion ------------------------------------------------- Number of shares of Common Stock to be Issued -------------------------------------------------- Applicable Conversion Price -------------------------------------------------- Name of Holder By:_______________________________________________ Name: Title: MILLENNIUM CELL INC. By:_______________________________________________ Name: Title: [ ] By the acceptance of this Conversion Notice the Holder represents and warrants to the Company that its ownership of the Common Stock does not exceed the restrictions set forth in Section 5(d)(i) of the Debenture. Schedule 1 CONVERSION SCHEDULE Debentures due March 28, 2006, in the aggregate principal amount of $4,000,000 issued by Millennium Cell Inc. This Conversion Schedule reflects conversions made under the above referenced Debentures. Dated: ------------------------------ -------------------------- --------------------- --------------------------------- Date of Conversion Amount of Conversion Aggregate Principal Applicable Conversion Price Amount Remaining Subsequent to Conversion ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --------------------------------- ------------------------------ -------------------------- --------------------- --...
Conversion calculations. Date to Effect Conversion: ----------------------------------- Principal Amount of Debenture to be Converted: ----------------------------------- Payment of Interest in Common Stock: /__/ YES /__/ NO If YES, :$_____________ of Interest accrued on Account of Conversion at Issue Number of Shares of Common Stock to be Issued: ---------------------------------- Signature: ---------------------------------- Print Name: ---------------------------------- Address: ----------------------------------
