Election to Convert. To: Vanstar Corporation The undersigned owner of this Security hereby irrevocably exercises the option to convert this Security, or the portion below designated, into Common Stock of Vanstar Corporation in accordance with the terms of the Indenture referred to in this Security, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise of its conversion rights in accordance with the terms of the Indenture and the Security, agrees to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- in whole _____ Portions of Security to be in part converted in part _____ ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- Signature (for conversion only) Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- Signature Guarantee:* --------------------- ------------------ *Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange.
Appears in 1 contract
Samples: Indenture (Inacom Corp)
Election to Convert. To: Vanstar Coeur D'Alene Mines Corporation The undersigned owner of this Security $________ ix xxxxxxxxx of Coeur D'Alene Mines Corporation's 13-3/8% Convertible Senior Subordinated Xxxxx xxx Xecember 31, 2003 (the "Convertible Note") hereby irrevocably exercises the option to convert this Securitythe Convertible Note, or the portion below designated, into Common Stock of Vanstar Coeur D'Alene Mines Corporation in accordance with the terms of the Indenture referred Indentxxx xxxxxxxd to in this Securitythe Convertible Note, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise Date: Amount of its conversion rights in accordance with the terms of the Indenture and the Security, agrees Convertible Note to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- in whole _____ Portions of Security to be in part converted in part _____ ($50 1,000 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- ); $----------------- Signature (for conversion only) -------------------------------- Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- Number: -------------------------------- -------------------------------- -------------------------------- -------------------------------- -------------------------------- -------------------------------- Signature Guarantee:* --------------------- ------------------ *Guarantee6 --------------- 6 Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange.
Appears in 1 contract
Samples: Coeur D Alene Mines Corp
Election to Convert. To: Vanstar Corporation Hanover Compressor Company The undersigned owner of this Security hereby irrevocably exercises the option to convert this Security, or the portion below designated, into Common Stock of Vanstar Corporation HANOVER COMPRESSOR COMPANY in accordance with the terms of the Indenture referred to in this Security, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise of its conversion rights in accordance with the terms of the Indenture and the Security, agrees to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- ---------------------- in whole _____ ---- Portions of Security to be in part converted in part _____ ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- ------------------------- Signature (for conversion only) -------------------------------- Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- ----------------------------------------------------------- ------------------------------------------------------------------------------ Signature Guarantee:* --------------------- ------------------ *Signature Guarantee:/6/ -------------------------------------- ------------------------ /6/(Signature must be guaranteed by an "eligible guarantor institution" that is, a commercial bank, trust company stockbroker, savings and loan association or member firm credit union meeting the requirements of the New York Stock ExchangeRegistrar, which requirements include membership or participation in the Securities Transfer Agents Medallion Program ("STAMP") or such other "signature guarantee program" as may be determined by the Registrar in addition to, or in substitution for, STAMP, all in accordance with the Securities Exchange Act of 1934, as amended.)
Appears in 1 contract
Election to Convert. To: Vanstar Suiza Foods Corporation The undersigned owner of this Security hereby irrevocably exercises the option to convert this Security, or the portion below designated, into Common Stock of Vanstar Suiza Foods Corporation in accordance with the terms of the Indenture referred to in this Security, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise of its conversion rights in accordance with the terms of the Indenture and the Security, agrees to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- --------------------------------- in whole _____ Portions of Security to be in part converted in part _____ converted ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- ---------------------------------- ------------------------------------ Signature (for conversion only) Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- ------------------------------------ ------------------------------------ ------------------------------------ Signature Guarantee:* --------------------- ------------------ *--------------- ------------------------- * Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange.
Appears in 1 contract
Samples: Suiza Foods Corp
Election to Convert. To: Vanstar Coeur d'Alene Mines Corporation The undersigned owner of this Security $________ ix xxxxxxxxx of Coeur d'Alene Mines Corporation's 9.0% Convertible Senior Subordinated Notex xxx Xxxxxary 26, 2007 (the "Convertible Note") hereby irrevocably exercises the option to convert this Securitythe Convertible Note, or the portion below designated, into Common Stock of Vanstar Coeur d'Alene Mines Corporation in accordance with the terms of the Indenture referred Indentuxx xxxxxxxx to in this Securitythe Convertible Note, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise Date: Amount of its conversion rights in accordance with the terms of the Indenture and the Security, agrees Convertible Note to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- in whole _____ Portions of Security to be in part converted in part _____ ($50 1,000 or integral multiples thereof): ); $ ----------------------------------------- ------------------------------------------- ------------------------ Signature (for conversion only) ----------------------------------------- Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- Number: ----------------------------------------- ----------------------------------------- ----------------------------------------- ----------------------------------------- Signature Guarantee:* --------------------- ------------------ *Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange.Guarantee(2)
Appears in 1 contract
Samples: Coeur D Alene Mines Corp
Election to Convert. To: Vanstar HMT Technology Corporation The undersigned owner of this Security $________ in principal of HMT Technology Corporation's 5 3/4% Convertible Subordinated Notes due 2004 (the "Convertible Note") hereby irrevocably exercises the option to convert this Securitythe Convertible Note, or the portion below designated, into Common Stock of Vanstar HMT Technology Corporation in accordance with the terms of the Indenture referred to in this Securitythe Convertible Note, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holderNoteholder, upon the exercise of its conversion rights in accordance with the terms of the Indenture and the SecurityConvertible Note, agrees to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the SecuritiesConvertible Note. Date: ------------------------- in whole Amount of Convertible Note to be converted ($1,000 or integral multiples thereof); $______________________ Portions of Security to be in part converted in part _____ ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- Signature (for conversion only) ________________________________________ Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- Signature Guarantee:* --------------------- ------------------ *Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange.Number
Appears in 1 contract
Samples: HMT Technology Corp
Election to Convert. To: Vanstar Coeur d'Xxxxx Xxxxx Corporation The undersigned owner of this Security $________ in principal of Coeur d'Xxxxx Xxxxx Corporation's 13 3/8% Convertible Senior Subordinated Notes due December 31, 2003 (the "Convertible Note") hereby irrevocably exercises the option to convert this Securitythe Convertible Note, or the portion below designated, into Common Stock of Vanstar Coeur d'Xxxxx Xxxxx Corporation in accordance with the terms of the Indenture referred to in this Securitythe Convertible Note, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise Date: Amount of its conversion rights in accordance with the terms of the Indenture and the Security, agrees Convertible Note to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- in whole converted ($1,000 or integral multiples thereof); $___________________________ Portions of Security to be in part converted in part _____ ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- Signature (for conversion only) Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- Number: _____________________________________ _____________________________________ _____________________________________ _____________________________________ Signature Guarantee:* --------------------- ------------------ *Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange.Guarantee(2)
Appears in 1 contract
Samples: Coeur D Alene Mines Corp
Election to Convert. To: Vanstar The AES Corporation The undersigned owner of this Security Debenture hereby irrevocably exercises the option to convert this SecurityDebenture, or the portion below designated, into Common Stock of Vanstar Corporation THE AES CORPORATION, in accordance with the terms of the Indenture referred to in this SecurityDebenture, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise of its conversion rights in accordance with the terms of the Indenture and the Security, agrees to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- in whole _____ Portions of Security to be in part converted in part ______, ____ in whole Portions of Debenture to be converted ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- $______ _________________________ Signature (for conversion only) Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- _________________________ _________________________ _________________________ Signature Guarantee:* --------------------- ------------------ *Guarantee:1______ -------- 1 Signature must be guaranteed by an "eligible guarantor institution" that is a commercial bank, trust company stockbroker, savings and loan association or member firm credit union meeting the requirements of the New York Stock Exchange.Conversion Agent, which requirements include membership of participation in the Securities Transfer Agents Medallion Program ("STAMP") or such other "signature guarantee program" as may be determined by the Conversion Agent in addition to, or in substitution for, STAMP, all in accordance with the Securities and Exchange Act of 1934, as amended. FOR VALUE RECEIVED, the undersigned assigns and transfers this Debenture to: ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- (Insert assignee's social security or tax identification number) ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- (Insert address and zip code of assignee) and irrevocably appoints ------------------------------------------------------- ------------------------------------------------------------------------------- agent to transfer -------------------------------------------------------------- this Debenture on the books of the Trust. The agent may substitute another to act for him or her. Date:_______________________________________
Appears in 1 contract
Samples: Aes Trust Vii
Election to Convert. To: Vanstar Coeur d'Alene Mines Corporation The undersigned owner of this Security $________ ix xxxxxxxxx of Coeur d'Alene Mines Corporation's 9.0% Convertible Senior Subordinated Notes dxx Xxxxxxxx 26, 2007 (the "Convertible Note") hereby irrevocably exercises the option to convert this Securitythe Convertible Note, or the portion below designated, into Common Stock of Vanstar Coeur d'Alene Mines Corporation in accordance with the terms of the Indenture referred to xxxxxxxx xx in this Securitythe Convertible Note, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise Date: Amount of its conversion rights in accordance with the terms of the Indenture and the Security, agrees Convertible Note to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the Securities. Date: ------------------------- in whole converted ($1,000 or integral multiples thereof); $______________________________ Portions of Security to be in part converted in part _____ ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- Signature (for conversion only) _______________________________ Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- Signature Guarantee:* --------------------- ------------------ *Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange.Number: _______________________________ _______________________________ _______________________________ __________________
Appears in 1 contract
Samples: First Supplemental Indenture (Coeur D Alene Mines Corp)
Election to Convert. To: Vanstar Corporation Frontier Insurance Group, Inc. The undersigned owner of this Security Debenture hereby irrevocably exercises the option to convert this SecurityDebenture, or the portion below designated, into Common Stock of Vanstar Corporation Frontier Insurance Group, Inc. in accordance with the terms of the Indenture referred to in this SecurityDebenture, and directs that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, be issued in the name of and delivered to the undersigned, unless a different name has been indicated in the assignment below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any holder, upon the exercise of its conversion rights in accordance with the terms of the Indenture and the SecurityDebenture, agrees to be bound by the terms of the Registration Rights Agreement relating to the Common Stock issuable upon conversion of the SecuritiesDebentures. Date: ------------------------- in whole ____________, ____ in whole __ Portions of Security Debenture to be in part converted in part _____ converted ($50 or integral multiples thereof): $ ----------------------------------------- ------------------------------------------- $__________________ ______________________________________________ Signature (for conversion only) Please Print or Typewrite Name and Address, Including Zip Code, and Social Security or Other Identifying Number ------------------------------------------- ------------------------------------------- ------------------------------------------- ______________________________________________ ______________________________________________ ______________________________________________ Signature Guarantee:* --------------------- ------------------ *-------- * Signature must be guaranteed by a commercial bank, trust company or member firm of the New York Stock Exchange., Inc.
Appears in 1 contract