FORM OF CONVERSION REQUEST Sample Clauses

FORM OF CONVERSION REQUEST. To: Bridge Bancorp, Inc. The undersigned owner of these Debentures hereby irrevocably elects to convert these Debentures, or the portion below designated, into Common Stock of the Company (the Common Stock) in accordance with the terms of the Indenture (the “Indenture”), dated as of October ___, 2009, between Bridge Bancorp, Inc., and Wilmington Trust Company, as Indenture Trustee. The undersigned owner of these Debentures hereby directs the Conversion Agent to convert such Debentures on behalf of the undersigned, into Common Stock (at the Conversion Ratio specified in the Indenture). The undersigned owner of these Debentures also hereby notifies the Conversion Agent that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, should 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 shall pay all transfer taxes payable with respect thereto.) Date: ____________________ Principal Amount of Debentures to be converted ($1,000 or integral multiples thereof): $ If a name or names other than the undersigned, please indicate in the spaces below the name or names in which the shares of Common Stock are to be issued, along with the address or addresses of such person or persons: (Sign exactly as your name appears on the other side of this Debenture) (for conversion only) Please print or type name and address, including zip code, and social security or other identifying number: Signature Guarantee:* * Signature must be guaranteed by an eligible guarantor institution that is a bank, stockbroker, savings and loan association or credit union meeting the requirements of the Registrar, 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 and Exchange Act of 1934, as amended.
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FORM OF CONVERSION REQUEST. To: Servisfirst Capital Trust II. and Wilmington Trust Company, or any successor Conversion Agent: The undersigned owner of these Preferred Securities hereby irrevocably elects to convert these Securities, or the portion below designated, into Company Common Stock in accordance with the terms of the Amended and Restated Trust Agreement (the "Trust Agreement"), dated as of March 15, 2010, between ServisFirst Bancshares, Inc., and Wilmington Trust Company, as Trustee. The undersigned owner of these Preferred Securities hereby directs the Conversion Agent to convert such Preferred Securities on behalf of the undersigned, into Company Common Stock (at the Conversion Price specified in the Trust Agreement). The undersigned owner of these Preferred Securities also hereby notifies the Conversion Agent that the shares issuable and deliverable upon conversion, together with any check in payment for fractional shares, should 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 shall pay all transfer taxes payable with respect thereto.) Date: ____________________ Liquidation Amount of Preferred Securities to be converted ($5,000 or integral multiples thereof): $ If a name or names other than the undersigned, please indicate in the spaces below the name or names in which the shares of Company Common Stock are to be issued, along with the address or addresses of such person or persons: (Sign exactly as your name appears on the other side of this Preferred Security) (for conversion only) Please print or type name and address, including zip code, and social security or other identifying number: Name: Address: SSN/TIN: Signature Guarantee:* * Signature must be guaranteed by an eligible guarantor institution that is a bank, stockbroker, savings and loan association or credit union meeting the requirements of the Registrar, 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. SCHEDULE A PREFERRED SECURITY OWNERSHIP INTEREST TABLE The initial aggregate liquidation amount of the Preferred Securities evidenced by the Certificate to which this Schedule A is attached ...
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FORM OF CONVERSION REQUEST. 9 CROSS-REFERENCE TABLE SECTION OF TRUST INDENTURE ACT SECTION OF OF 1939, AS AMENDED INDENTURE ------------------- ----------
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Related to FORM OF CONVERSION REQUEST

  • Form of Conversion Notice Each convertible Security shall have attached thereto, or set forth on the reverse of the Security, a notice of conversion in substantially the following form: Conversion Notice To: Xxxxxxxx Offshore Services, Inc. The undersigned owner of this Security hereby: (i) irrevocably exercises the option to convert this Security, or the portion hereof below designated, for shares of Common Stock of Xxxxxxxx Offshore Services, Inc. in accordance with the terms of the Indenture referred to in this Security and (ii) directs that such shares of Common Stock deliverable upon the conversion, together with any check in payment for fractional shares and any Security(ies) representing any unconverted principal amount hereof, be issued and delivered to the registered holder hereof unless a different name has been indicated below. If shares are to be delivered registered in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto. Any amount required to be paid by the undersigned on account of interest accompanies this Security. Dated: Signature Fill in for registration of shares if to be delivered, and of Securities if to be issued, otherwise than to and in the name of the registered holder. (Name) Social Security or other Taxpayer Identification Number (Please print name and address) Principal amount to be converted: (if less than all) $ . Signature Guarantee* * Participant in a recognized Signature Guarantee Medallion Program (or other signature acceptable to the Trustee).

  • Conversion Request A notice given by the Borrower to the Agent of its election to convert or continue a Loan in accordance with Section 4.1.

  • Conversion/Continuation Request A notice given by the Borrower to the Agent of its election to convert or continue a Loan in accordance with §4.1.

  • Notice of Conversion/Continuation a Notice of Conversion/Continuation to be provided by Borrower Agent to request a conversion or continuation of any Loans as LIBOR Loans, in form satisfactory to Agent.

  • Conversion Agent to Notify Company of Conversions If any Note is submitted for conversion to the Conversion Agent or the Conversion Agent receives any notice of conversion with respect to a Note, then the Conversion Agent will promptly notify the Company and the Trustee of such occurrence, together with any other information reasonably requested by the Company, and will cooperate with the Company to determine the Conversion Date for such Note.

  • Notice of Calculation of Conversion Consideration If Cash Settlement or Combination Settlement applies to the conversion of any Note, then the Company will determine the Conversion Consideration due thereupon promptly following the last VWAP Trading Day of the applicable Observation Period and will promptly thereafter send notice to the Trustee and the Conversion Agent of the same and the calculation thereof in reasonable detail. Neither the Trustee nor the Conversion Agent will have any duty to make any such determination.

  • Redemption Requests Receive for acceptance requests and directions from Institutions and Accounts for the redemption of Series shares transmitted or delivered to the office of the Administrator, note the time and date of each request when received, process such requests and directions in accordance with the redemption procedures set forth in the then current Prospectus and Statement of Additional Information ("SAI") of the Series, and deliver the appropriate documentation to the Custodian;

  • NOTICE OF CONVERSION The undersigned hereby elects to convert principal under the Convertible Note due August 24, 2021 of Pacific Software, Inc., a Nevada corporation (the “Borrower”), into shares of common stock (the “Common Stock”), of Borrower according to the conditions hereof, as of the date written below. If shares of Common Stock 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 and is delivering herewith such certificates and opinions as reasonably requested by Borrower in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. By the delivery of this Notice of Conversion the undersigned represents and warrants to Borrower that its ownership of the Common Stock does not exceed the amounts specified under Section 4 of this Note, as determined in accordance with Section 13(d) of the Exchange Act. The undersigned agrees to comply with the prospectus delivery requirements under the applicable securities laws in connection with any transfer of the aforesaid shares of Common Stock. Conversion calculations: Date to Effect Conversion:______________________________________ Principal Amount of Note to be Converted: $_______________________ Number of shares of Common Stock to be issued: ___________________ Signature: _______________________ Name: _______________________ Address for Delivery of Common Stock Certificates: ________________ __________________________________________________________ __________________________________________________________ Or DWAC Instructions: __________________________________________ Broker No: _________________ Account No: ________________

  • Processing Redemption Requests You shall not purchase any share of any of the Funds from a record holder at a price lower than the net asset value next determined by or for the Funds’ shares. You shall, however, be permitted to sell any shares for the account of a shareholder of the Funds at the net asset value currently quoted by or for the Funds’ shares, and may charge a fair service fee for handling the transaction provided you disclose the fee to the record owner.

  • Borrowing/Election Notice The Borrower shall give the Administrative Agent an irrevocable Borrowing/Election Notice of each conversion of a Floating Rate Loan into a Eurodollar Rate Loan or continuation of a Eurodollar Rate Loan not later than 11:00 a.m. (Chicago time) three (3) Business Days prior to the date of the requested conversion or continuation, specifying: (i) the requested date (which shall be a Business Day) of such conversion or continuation; (ii) the amount and Type of the Loan to be converted or continued; and (iii) the amount of Eurodollar Rate Loan(s) into which such Loan is to be converted or continued, and the duration of the Interest Period applicable thereto.

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