Common use of FORM OF ELECTION TO PURCHASE Clause in Contracts

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, _____ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKO'REILLY AUTOMOTIVE, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ___,__ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. ACACIA RESEARCH CORPORATION: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number _____(Please print name and address) Dated _______________ (Please print name and address) Dated: _____________________, __20___ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKSORRENTO THERAPEUTICS, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, _____ Signature Signature Guaranteed:: Signatures must be guaranteed by a participant in the Medallion Signature Guarantee Program at a guarantee level acceptable to the Company’s Rights Agent.

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKBEAZER HOMES USA, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): Dated: _____________________, _____ Signature Signature: Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, CXXXX & COMPANY INC. .: The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ________________________ (Please print name and address) ): If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): Dated: _____________________, _____ Signature Signature: Signature Guaranteed*: * Signatures must be guaranteed by a participant in a Medallion Signature Guarantee Program at a guarantee level satisfactory to the Rights Agent. A notary public is not sufficient. Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKENZON PHARMACEUTICALS, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ___________________________ (Please print name and address) ): If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): Dated: _____________________, _____ Signature Signature: Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKINSTITUTIONAL FINANCIAL MARKETS, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): Dated: _____________________, _____ Signature Signature: Signature Guaranteed*: * Signatures must be guaranteed by a participant in a Medallion Signature Guarantee Program at a guarantee level satisfactory to the Rights Agent. A notary public is not sufficient. Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. INTERDIGITAL COMMUNICATIONS CORPORATION The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares Units of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person or other property which may be issuable upon the exercise of the Rights) and requests that certificates for such shares Units be issued in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) number: --------------------------------- If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) Datednumber: _____________________, _____ -------------------------------- Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKX. X. XXXXXX COMPANY, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number _____(Please print name and address) Dated _______________ (Please print name and address) Dated: ____, 20___ _____________________, ______ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. Houston Wire & Cable Company The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: ________________, ____ _____, _________________________________ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, DRIVE SHACK INC. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ,_____ Signature Signature Guaranteed:: Signature must be guaranteed by a bank, trust company, broker, dealer or other eligible institution participating in a recognized signature guarantee medallion program.

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKTOLL BROTHERS, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): Dated: _____________________, _____ Signature Signature: Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKINTERDIGITAL, INC. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares Units of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person or other property which may be issuable upon the exercise of the Rights) and requests that certificates for such shares Units be issued in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) number: If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) Datednumber: _____________________, _____ Signature Signature Guaranteed: CERTIFICATE The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANKTo CAPITAL TRUST, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered toof: Please insert social security or other identifying number ____________________ taxpayer number: (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Right Certificate or if the Rights Certificateare being exercised pursuant to Section 11(a)(ii) of the Rights Agreement, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ taxpayer number: (Please print name and address) Dated: _____________________, _____ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if the holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKEMBREX, INC. The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) number: If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number number: Dated: __________________, 20__ (Please print name and address) DatedSignature Signature Guaranteed: _____________________, ________ Signature Signature GuaranteedCertificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, EAGLE MATERIALS INC. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating A Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company Corporation or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and addressPLEASE PRINT NAME AND ADDRESS) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and addressPLEASE PRINT NAME AND ADDRESS) Dated: _____________________, _____ Signature Signature Guaranteed: 5 CERTIFICATE The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. CORECOMM LIMITED: The undersigned hereby irrevocably elects to exercise ___________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating C Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, _____ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Right Certificate.) ToTo FLUSHING FINANCIAL CORPORATION: SWANK, INC. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock Shares issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered toof: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: ______Dated as of _______________, _____ Signature Signature Guaranteed: BACK Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. FIRST AMERICAN CORPORATION The undersigned hereby irrevocably elects to exercise ___________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: ______________________ , _____ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKX. X. XXXXXX COMPANY, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number _____(Please print name and address) Dated _______________ (Please print name and address) Dated: _____________________, __20___ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) ToTO: SWANKSOLITRON DEVICES, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: (Please print name and address of transferee) Please insert social security or other identifying number number: _____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address of transferee) Please insert social security or other identifying number ____________________ (Please print name and address) Dated: number:_____________________, _ Dated: __________________ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. ROSEVILLE COMMUNICATIONS COMPANY The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock Common Shares issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares (or other securities) be issued in the name of and delivered to: (Please print name and address) (Please insert social security or other identifying number ____________________ (Please print name and addressnumber) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address) (Please insert social security or other identifying number ____________________ (Please print name and addressnumber) Dated: _____________________, _____ Signature Signature: Signature Guaranteed: CERTIFICATE The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. X. X. XXXXXXXXX & SONS COMPANY.: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ___,__ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. Steel Excel Inc. The undersigned hereby irrevocably elects to exercise _______________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and addressaddress of transferee) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and addressaddress of transferee) Dated: _____________________, ___20__ Signature Medallion Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKBEAZER HOMES USA, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): Dated: _____________________, ____________ Signature: _________________________________ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKHEALTH NET, INC. The undersigned hereby irrevocably elects to exercise __________________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ------------------------------------------------------------------------------ Dated: _____________________, __20___ ------------------------------ Signature Signature Medallion Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented evidenced by the Rights Right Certificate.) To: SWANK, INC. BROADWAY FINANCIAL CORPORATION The undersigned hereby irrevocably elects to exercise __________ Rights represented evidenced by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock Shares issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which as may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered toof: Please insert social security or other identifying number ____________________ (Please print name and address) Please insert Social Security or other identifying number: If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) DatedPlease insert Social Security or other identifying number: _____________________Date: , _____ 20 Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKINSTITUTIONAL FINANCIAL MARKETS, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) ): Dated: _____________________, _____ Signature Signature: Signature Guaranteed:*: * Signatures must be guaranteed by a participant in a Medallion Signature Guarantee Program at a guarantee level satisfactory to the Rights Agent. A notary public is not sufficient.

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. Callidus Software Inc. The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ___20__ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. Triad Guaranty Inc. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ___,20__ Signature Medallion Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. XXX.Xxxxxxxx Corporation The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: ___:__________________, ___20__ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, EAGLE BULK SHIPPING INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ___,__ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANKInterline Brands, INC. Inc. The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: ________________, ____ _____, _________________________________ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, LONE STAR ENERGY PLANT OPERATIONS INC. : The undersigned hereby irrevocably elects to exercise _____________________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: ______________________, __19___ Signature Signature Guaranteed: 50 Certificate ----------- The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANKPiccadilly Cafeterias, INC. Inc. The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ___19__ Signature Signature GuaranteedPAGE CERTIFICATE The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKCPEX PHARMACEUTICALS, INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, _____ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. The undersigned hereby irrevocably elects to exercise ___________________ The undersigned hereby irrevocably elects to exercise Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number number: _____________________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) Datednumber: _____________________ _, ______________________________________ Dated: , Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. THE STRIDE RITE CORPORATION: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ ------------------------------- (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ -------------------------------- (Please print name and address) Dated: ______________________ , _____ 19 Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, SOLUTIA INC. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _______________,__ ______, _________________________ Signature Signature: Signature Guaranteed: K&E 15230038.6 Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANKFLORIDA EAST COAST INDUSTRIES, INC. The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number (Please print name and address) Dated: ________________, ____ (Please print name and address) Dated: _____________________, ________ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. XXXXXX DRILLING COMPANY The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares (or other securities) be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, __20___ Signature Signature Guaranteed:: Signatures must be guaranteed by an “eligible guarantor institution” (as defined pursuant to Rule 17Ad-15 under the Securities Exchange Act of 1934, as amended).

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANKThe Williams Companies, INC. Inc.: The undersigned hereby irrevocably elects xxxxxx to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number (Please print name and address) Dated: ________________, ____ (Please print name and address) Dated: _____________________, ______ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. FURMANITE CORPORATION The undersigned hereby irrevocably elects to exercise __________ ___Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please please print name and address) Dated: ___________________, __, _______ Signature Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. SUREWEST COMMUNICATIONS The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock Common Shares issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares (or other securities) be issued in the name of and delivered to: (Please print name and address) (Please insert social security or other identifying number ____________________ (Please print name and addressnumber) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address) (Please insert social security or other identifying number ____________________ (Please print name and addressnumber) Dated: _____________________, _____ Signature Signature: ____________________ Signature Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. TASTY BAKING COMPANY The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock Common Shares issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered toof: Please insert social security or other identifying number ___________________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number _number___________________ (Please print name and address) Dated: _____________________, ___200__ Signature Signature Guaranteed:: Signatures must be guaranteed by an eligible financial institution or broker who is a member participant in a Medallion Program approved by the Securities Transfer Association, Inc.

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. Wits Basin Precious Minerals Inc. The undersigned hereby irrevocably elects to exercise ____________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which that may be issuable upon the exercise of the Rights) and requests that certificates for such shares securities be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, _____ Signature Signature Guaranteed: CERTIFICATE The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. ChinaCache International Holdings Ltd. The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock Shares issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ________________________________________________ Please insert social security or other identifying number (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ________________________________________________ Please insert social security or other identifying number (Please print name and address) Dated: _____________________, ___,__ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if the registered holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. The undersigned hereby irrevocably elects to exercise ___________________ The undersigned hereby irrevocably elects to exercise Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person Person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) number: If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: (Please print name and address) Please insert social security or other identifying number ____________________ (Please print name and address) number: Dated: _____________________, _____ . Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. BALL CORPORATION The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) address If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) address Dated: _____________________, ____ ___________________________ Signature Signature Medallion Guaranteed:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, EAGLE BULK SHIPPING INC. .: The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: _____________________, ___,__ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Certificate.) To: SWANK, INC. INSTINET GROUP INCORPORATED The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Certificate to purchase the shares of Series E Junior Participating Preferred Stock issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Certificate, a new Rights Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ (Please print name and address) Dated: __________________, ___, __ ______________________________ Signature Signature Guaranteed: Certificate The undersigned hereby certifies by checking the appropriate boxes that:

FORM OF ELECTION TO PURCHASE. (To be executed if holder desires to exercise Rights represented by the Rights Right Certificate.) To: SWANK, INC. PRIMESOURCE CORPORATION The undersigned hereby irrevocably elects to exercise __________ Rights represented by this Rights Right Certificate to purchase the shares of Series E Junior Participating Preferred Stock Common Shares issuable upon the exercise of the Rights (or such other securities of the Company or of any other person which may be issuable upon the exercise of the Rights) and requests that certificates for such shares be issued in the name of and delivered toof: Please insert social security or other identifying number ___________________________ (Please print name and address) If such number of Rights shall not be all the Rights evidenced by this Rights Right Certificate, a new Rights Right Certificate for the balance of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number ____________________ ---------------------------------------------------------- (Please print name and address) Dated: _____________________, ___200__ Signature Signature Guaranteed:: Signatures must be guaranteed by an eligible financial institution or broker who is a member participant in a Medallion Program approved by the Securities Transfer Association, Inc.