Guaranteed. By: ----------------------------------- THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15 ---------------------------------------------------------------- The undersigned hereby certifies that the Rights evidenced by this Right Certificate are not beneficially owned by an Acquiring Person or an Affiliate or Associate thereof (as defined in the Rights Agreement). ---------------------------------- Signature Form of Reverse Side of Right Certificate--continued FORM OF ELECTION TO PURCHASE (To be executed if holder desires to exercise the Right Certificate) To _______________________: The undersigned hereby irrevocably elects to exercise _____________ Rights represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares be issued in the name of: Please insert social security or other identifying number --------------------------------------------- --------------------------------------------- If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining 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
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Guaranteed. By: ----------------------------------- THE SIGNATURE(SNo transfer of the Common Units evidenced hereby will be registered on the books of the Partnership, unless the Certificate evidencing the Common Units to be transferred is surrendered for registration or transfer and an Application for Transfer of Common Units has been executed by a transferee either (a) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION on the form set forth below or (BANKSb) on a separate application that the Partnership will furnish on request without charge. A transferor of the Common Units shall have no duty to the transferee with respect to execution of the transfer application in order for such transferee to obtain registration of the transfer of the Common Units. -------------------------------------------------- APPLICATION FOR TRANSFER OF COMMON UNITS The undersigned ("Assignee") hereby applies for transfer to the name of the Assignee of the Common Units evidenced hereby. The Assignee (a) requests admission as a Substituted Limited Partner and agrees to comply with and be bound by, STOCKBROKERSand hereby executes, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAMthe Third Amended and Restated Agreement of Limited Partnership of Ferrellgas Partners, L.P. (the "Partnership"), PURSUANT TO S.E.C. RULE 17Ad-15 ---------------------------------------------------------------- The as amended, supplemented or restated to the date hereof (the "Partnership Agreement"), (b) represents and warrants that the Assignee has all right, power and authority and, if an individual, the capacity necessary to enter into the Partnership Agreement, (c) grants the powers of attorney provided for in the Partnership Agreement and (d) makes the waivers and gives the consents and approvals contained in the Partnership Agreement. Capitalized terms not defined herein have the meanings assigned to such terms in the Partnership Agreement. Date: -------------------- --------------------------------------- Signature of Assignee ------------------------------------- --------------------------------------- Social Security or other identifying Name and Address of Assignee number of Assignee -------------------------------------- Purchase Price including commissions, if any Type of Entity (check one) Individual Partnership Corporation -------------- ----------- ---------------------- Trust Other (specify) -------------------- ----------- -------------------- Nationality (Check One): U.S. Citizen, Resident or Domestic Entity --------- Foreign Corporation, or Non-resident alien --------- --------- If the U.S. Citizen, Resident or Domestic Entity box is checked, the following certification must be completed. Under Section 1445(e) of the Internal Revenue Code of 1986, as amended (the "Code"), the Partnership must withhold tax with respect to certain transfers of property if a holder of an interest in the Partnership is a foreign person. To inform the Partnership that no withholding is required with respect to the undersigned interest holder's interest in it, the undersigned hereby certifies that the Rights evidenced by this Right Certificate are not beneficially owned by an Acquiring Person or an Affiliate or Associate thereof following (as defined in or, if applicable, certifies the Rights Agreementfollowing on behalf of the interest holder). ---------------------------------- Signature Form of Reverse Side of Right Certificate--continued FORM OF ELECTION TO PURCHASE (To be executed if holder desires to exercise the Right Certificate) To _______________________: The undersigned hereby irrevocably elects to exercise _____________ Rights represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares be issued in the name of: Please insert social security or other identifying number --------------------------------------------- --------------------------------------------- If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining 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.
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Guaranteed. By: ----------------------------------- THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), ) PURSUANT TO S.E.C. SEC RULE 17Ad-15 ---------------------------------------------------------------- 17Ad-15. 24 [TO BE DELETED UNLESS HOLDER HAS OPTION TO ELECT REPAYMENT] REGISTRAR, PAYING AGENTS AND TRANSFER AGENT REGISTRAR AND PAYING AGENT (subject to change) SunTrust Bank Corporate Trust Department Mail Code 008 25 Pxxx Xxxxx, 00xx Xxxxx Atlanta, Georgia 30303 OPTION TO ELECT REPAYMENT The undersigned hereby certifies that irrevocably requests and instructs the Rights evidenced by this Right Certificate are not beneficially owned by an Acquiring Person Company to repay the within Note (or an Affiliate or Associate portion hereof specified below) pursuant to its terms at a price equal to the applicable repayment price thereof (as defined in together with interest to the Rights Agreement). ---------------------------------- Signature Form of Reverse Side of Right Certificate--continued FORM OF ELECTION TO PURCHASE (To be executed if holder desires repayment date, to exercise the Right Certificate) To undersigned: _______________________: The undersigned hereby irrevocably elects to exercise _______________________________________________ Rights represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares be issued in the name of: Please insert social security or other identifying number --------------------------------------------- --------------------------------------------- If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of and delivered to: Please insert social security or other identifying number --------------------------------------------- (Please print or typewrite name and addressaddress of the undersigned) --------------------------------------------- --------------------------------------------- DatedIf less than the entire principal amount of the within Note is to be repaid, specify the portion thereof which the Holder elects to have repaid: __________, ______ ---------------------------------- and specify the denomination or denominations (which shall be in Authorized Denominations) of the Notes to be issued to the Holder for the portion of the within Note not being repaid (in the absence of any such specification, one such Note will be issued for the portion not being repaid): _____________________________________________ Date:__________________________ Signature: ________________________________ ABBREVIATIONS The following abbreviations, when used in the instruction on the face of this instrument, shall be construed as though they were written out in full according to applicable laws or regulations: TEN COM - as tenants in common TEN ENT - as tenants by the entirety JT TEN- as joint tenants with right of survivorship and not as tenants in common UNIF GIFT MIN ACT - ____________________ Custodian for_________________ (Cust) (Minor) Under Uniform Gifts to Minors Act (State)
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Samples: Textron Financial Corp
Guaranteed. By: ----------------------------------- THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15 ---------------------------------------------------------------- --------------------------------------- The undersigned hereby certifies that the Rights evidenced by this Right Certificate are not beneficially owned by an Acquiring Person or an Affiliate or Associate thereof (as defined in the Rights Agreement). ---------------------------------- ----------------------------------- Signature [SIGNATURE PAGE TO FORM OF RIGHT CERTIFICATE] 42 Form of Reverse Side of Right Certificate--continued FORM OF ELECTION TO PURCHASE (To be executed if holder desires to exercise the Right Certificate) To _______________________: The undersigned hereby irrevocably elects to exercise _____________ Rights represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares be issued in the name of: Please insert social security or other identifying number --------------------------------------------- --------------------------------------------- number: ---------------------------------------------------------- (Please print name and address) ---------------------------------------------------------- ---------------------------------------------------------- If such If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining 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(s) Guaranteed: SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION (BANKS, ____ ---------------------------------- SignatureSTOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15.
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Guaranteed. By: ----------------------------------- THE SIGNATURE(SNo transfer of the Common Units evidenced hereby will be registered on the books of the Partnership, unless the Certificate evidencing the Common Units to be transferred is surrendered for registration or transfer and an Application for Transfer of Common Units has been executed by a transferee either (a) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION on the form set forth below or (BANKS, STOCKBROKERS, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM), PURSUANT TO S.E.C. RULE 17Ad-15 ---------------------------------------------------------------- The undersigned hereby certifies b) on a separate application that the Rights evidenced by this Right Certificate are not beneficially owned by an Acquiring Person or an Affiliate or Associate thereof (as defined Partnership will furnish on request without charge. A transferor of the Common Units shall have no duty to the transferee with respect to execution of the transfer application in order for such transferee to obtain registration of the Rights Agreement)transfer of the Common Units. ---------------------------------- Signature Form of Reverse Side of Right Certificate--continued FORM OF ELECTION TO PURCHASE (To be executed if holder desires to exercise the Right Certificate) To _______________________: The undersigned hereby irrevocably elects to exercise _____________________________________________________ Rights represented by this Right Certificate APPLICATION FOR TRANSFER OF COMMON UNITS The undersigned ("ASSIGNEE") hereby applies for transfer to purchase the Preferred Shares issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares be issued in the name of: Please insert social security or other identifying number --------------------------------------------- --------------------------------------------- If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining of such Rights shall be registered in the name of the Assignee of the Common Units evidenced hereby. The Assignee (a) requests admission as a Substituted Limited Partner and delivered to: Please insert social security agrees to comply with and be bound by, and hereby executes, the Amended and Restated Agreement of Limited Partnership of Northern Border Partners, L.P. (the "Partnership"), as amended, supplemented or other identifying number --------------------------------------------- restated to the date hereof (Please print name the "PARTNERSHIP AGREEMENT"), (b) represents and addresswarrants that the Assignee has all right, power and authority and, if an individual, the capacity necessary to enter into the Partnership Agreement, (c) --------------------------------------------- --------------------------------------------- Dated: gives the powers of attorney provided for in the Partnership Agreement and (d) makes the waivers and gives the consents and approvals contained in the Partnership Agreement. Capitalized terms not defined herein have the meanings assigned to such terms in the Partnership Agreement. Date:__________, _________________ ---------------------------------- Signature__________________________________ Signature of Assignee _________________________________ __________________________________ Social Security or other Name and Address of Assignee identifying number of Assignee _________________________________ Purchase Price including commissions, if any Type of Entity (check one) ________________Individual_______________Partnership________________Corporation ________________Trust____________________Other (specify)______________________ Nationality (Check One):
Appears in 1 contract
Samples: Northern Border Partners Lp
Guaranteed. By: ----------------------------------- THE SIGNATURE(SNo transfer of the Common Units evidenced hereby will be registered on the books of the Partnership, unless the Certificate evidencing the Common Units to be transferred is surrendered for registration or transfer and an Application for Transfer of Common Units has been executed by a transferee either (a) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR INSTITUTION on the form set forth below or (BANKSb) on a separate application that the Partnership will furnish on request without charge. A transferor of the Common Units shall have no duty to the transferee with respect to execution of the transfer application in order for such transferee to obtain registration of the transfer of the Common Units. APPLICATION FOR TRANSFER OF COMMON UNITS The undersigned ("Assignee") hereby applies for transfer to the name of the Assignee of the Common Units evidenced hereby. The Assignee (a) requests admission as a Substituted Limited Partner and agrees to comply with and be bound by, STOCKBROKERSand hereby executes, SAVINGS AND LOAN ASSOCIATIONS AND CREDIT UNIONS WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAMthe Amended and Restated Agreement of Limited Partnership of AmeriGas Partners, L.P. (the "Partnership"), PURSUANT TO S.E.C. RULE 17Ad-15 ---------------------------------------------------------------- The undersigned hereby certifies as amended, supplemented or restated to the date hereof (the "Partnership Agreement"), (b) represents and warrants that the Rights evidenced by this Right Certificate are not beneficially owned by Assignee has all right, power and authority and, if an Acquiring Person or an Affiliate or Associate thereof individual, the capacity necessary to enter into the Partnership Agreement, (as defined c) grants the powers of attorney provided for in the Rights Partnership Agreement and (d) makes the waivers and gives the consents and approvals contained in the Partnership Agreement). ---------------------------------- Capitalized terms not defined herein have the meanings assigned to such terms in the Partnership Agreement. Date: Signature Form of Reverse Side Assignee Social Security or other Name and Address of Right Certificate--continued FORM OF ELECTION TO PURCHASE Assignee identifying number of Assignee Purchase Price including commissions, if any Type of Entity (To be executed if holder desires to exercise the Right Certificatecheck one) To _______________________: The undersigned hereby irrevocably elects to exercise _____________________ Rights represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise of such Rights and requests that certificates for such Preferred Shares be issued in the name of: Please insert social security or other identifying number --------------------------------------------- --------------------------------------------- If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new Right Certificate for the balance remaining 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: Individual -------------------------------------------- __________, ____________________________ ---------------------------------- SignaturePartnership _________________________________ Corporation _________________________Trust _____________________ Other ------------------------- (specify)_______________________________________________________________________ ------------- Nationality (Check One) _______________________ U.S. Citizen, Resident or Domestic Entity ----------------------- _______________________ Foreign Corporation, or ----------------------- -------------------------------------------------------------------------------- ___ Non-resident alien If the U.S. Citizen, Resident or Domestic Entity box is checked, the following certification must be completed. Under Section 1445(e) of the Internal Revenue Code of 1986, as amended (the "Code"), the Partnership must withhold tax with respect to certain transfers of property if a holder of an interest in the Partnership is a foreign person. To inform the Partnership that no withholding is required with respect to the undersigned interest holder's interest in it, the undersigned hereby certifies the following (or, if applicable, certifies the following on behalf of the interest holder).
Appears in 1 contract
Samples: Agreement (Amerigas Partners Lp)