Common use of SETTLEMENT INSTRUCTIONS Clause in Contracts

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Units evidenced by this Stripped Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ Signature Signature Guarantee: If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any ------------------------------------

Appears in 2 contracts

Samples: Purchase Contract Agreement (Dte Energy Co), Purchase Contract Agreement (Dte Energy Co)

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SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Stock Purchase Units evidenced by this Stripped Unit Stock Purchase Units Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:: _________________________________ _________________________________ Signature Signature Guarantee: _____________________ (if assigned to another person) If shares are to be registered in the name of and delivered to a Person other than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your Registered Holder. Please print name and address of signature: ___________________________________ ___________________________________ Name Name ___________________________________ Signature Signature Guarantee: If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ ___________________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ Social Security or other Taxpayer Identification Number, if any ------------------------------------________________________

Appears in 1 contract

Samples: Stock Purchase Contract Agreement (Widepoint Corp)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Stock Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Equity Security Units evidenced by this Stripped Equity Security Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated: ___________________ Signature:______________________________ Signature Guarantee:____________________ (if assigned to another person) If shares are to be registered in the REGISTERED HOLDER Please print name of and delivered to a Person other name and address of Registered Holder: than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your signature: ___________________________________ ________________________________________ Signature Signature Guarantee: If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ ___________________________________ ________________________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any ------------------------------------any

Appears in 1 contract

Samples: Purchase Contract Agreement (Dte Energy Co)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Corporate Stock Purchase Units evidenced by this Stripped Corporate Stock Purchase Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:: _______________________ _____________________________________ Signature Signature Guarantee: _________________ (if assigned to another person) If shares are to be registered in the name of REGISTERED HOLDER and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ _____________________________________ _____________________________________ Name Name --------------------------------- ------------------------------------ _____________________________________ _____________________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ Social Security or other Taxpayer Identification _____________________________________ Number, if any ------------------------------------any

Appears in 1 contract

Samples: Purchase Contract Agreement (Dominion Resources Capital Trust Iv)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Units Growth PRIDES evidenced by this Stripped Unit Growth PRIDES Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : ------------------------------- ----------------------------- Signature Signature Guarantee: If shares are to be registered in the name of and delivered to REGISTERED HOLDER to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ -------------------------------- ------------------------------- Name Name --------------------------------- ------------------------------------ -------------------------------- ------------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ -------------------------------- ------------------------------- -------------------------------- ------------------------------- -------------------------------- ------------------------------- Social Security or other Taxpayer Identification Number, if any -------------------------------------------------------------------

Appears in 1 contract

Samples: Purchase Contract Agreement (Cendant Corp)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Final Settlement Date of the Purchase Contracts underlying the number of Stripped Units Securities evidenced by this Stripped Unit Security Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : -------------------------- ----------------------------------- Signature Signature Guarantee: If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the REGISTERED HOLDER Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ ----------------------------------- Name Name --------------------------------- ------------------------------------ ----------------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ----------------------------------- Social Security or other Taxpayer Identification Number, if any -----------------------------------------------------------------------

Appears in 1 contract

Samples: Purchase Contract Agreement (Medpartners Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Final Settlement Date of the Purchase Contracts underlying the number of Stripped Units Securities evidenced by this Stripped Unit Security Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : ----------------- ----------------------- Signature Signature Guarantee: If shares are to be registered in the name of and delivered to REGISTERED HOLDER to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ ------------------------- ----------------------------- Name Name --------------------------------- ------------------------------------ ------------------------- ----------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ------------------------- ----------------------------- Social Security or other Taxpayer Identification ----------------------------- Number, if any ------------------------------------any

Appears in 1 contract

Samples: Purchase Contract Agreement (CMS Energy Trust Ii)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying relating to the number of Stripped Corporate Units evidenced by this Stripped Corporate Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will agrees to pay any transfer tax payable incident thereto. Dated:____: ___________________ _______________________ Signature Signature Guarantee: _________________ Signature Signature Guarantee(if assigned to another person) REGISTERED HOLDER Please print name and address of Registered Holder: -------------------------------------------------------------------------------- (insert name) -------------------------------------------------------------------------------- (insert address) -------------------------------------------------------------------------------- (insert social security or other taxpayer identification number, if any) ------------------------ If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your signature: -------------------------------------------------------------------------------- (insert name) -------------------------------------------------------------------------------- (insert address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security ) -------------------------------------------------------------------------------- (insert social security or other Taxpayer Identification Numbertaxpayer identification number, if any ------------------------------------any)

Appears in 1 contract

Samples: Purchase Contract Agreement (Ohio Casualty Corp)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Treasury Units evidenced by this Stripped Treasury Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:: _______________________ _______________________________ Signature Signature Guarantee: _______________________________ (if assigned to another person) If shares are to be registered in the name of and delivered to REGISTERED HOLDER a Person other than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: _______________________________ _______________________________ Name Name _______________________________ _______________________________ Address Address Social Security or other Taxpayer Identification Number, if any _______________________________ Transfer Instructions for Pledged Treasury Units Transferable Upon a Termination Event: ________________________________________________________________ ________________________________________________________________ Signature Signature Guarantee: If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any ------------------------------------________________________________________________________________

Appears in 1 contract

Samples: Purchase Contract Agreement (Nisource Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped PEPS Units evidenced by this Stripped Unit PEPS Units Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ______ _______________________________ Signature Signature Guarantee: :___________ (if assigned to another person) If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other REGISTERED HOLDER than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ _______________________________ _______________________________ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any ------------------------------------_______________________________

Appears in 1 contract

Samples: Purchase Contract Agreement (Ucu Capital Trust I)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for Common Stock Ordinary Shares deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying relating to the number of Stripped Corporate Units evidenced by this Stripped Corporate Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will agrees to pay any transfer tax payable incident thereto. Dated:____: ___________________ _______________________ Signature Signature Guarantee: __________________ Signature Signature Guarantee(if assigned to another person) REGISTERED HOLDER Please print name and address of Registered Holder: -------------------------------------------------------------------------------- (insert name) -------------------------------------------------------------------------------- (insert address) -------------------------------------------------------------------------------- (insert social security or other taxpayer identification number, if any) ------------------------ If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your signature: -------------------------------------------------------------------------------- (insert name) -------------------------------------------------------------------------------- (insert address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security ) -------------------------------------------------------------------------------- (insert social security or other Taxpayer Identification Numbertaxpayer identification number, if any ------------------------------------any)

Appears in 1 contract

Samples: Purchase Contract Agreement (Endurance Specialty Holdings LTD)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for Common Stock Shares deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Units Type A Securities evidenced by this Stripped Unit Type A Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : ---------------------- --------------------------------------- Signature Signature Guarantee: ------------------------------- (if assigned to another person) Signatures must be guaranteed by an "eligible guarantor institution" meeting the requirements of the Registrar, which requirements include membership or participation in the Security Transfer Agent Medallion Program ("STAMP") or such other "signature guarantee program" as may be determined by the Registrar in addition to, or in substitution for, STAMP, all in accordance with the Securities Exchange Act of 1934, as amended. If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ ----------------------------- ------------------------ Name Name --------------------------------- ------------------------------------ ----------------------------- ------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ----------------------------- ------------------------- ------------------------- Social Security or other Taxpayer Identification Number, if any ------------------------------------any

Appears in 1 contract

Samples: Purchase Contract Agreement (Arvin Industries Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped New PEPS Units evidenced by this Stripped Unit New PEPS Units Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : ------------------------ -------------------------------- Signature Signature Guarantee: ------------ (if assigned to another person) If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other REGISTERED HOLDER than the Holder, please (i) print such Person's name and address: address and (ii) provide Please print name and address of a guarantee of your signature: Registered Holder: --------------------------------- ------------------------------------ ------------------------------- -------------------------------- Name Name --------------------------------- ------------------------------------ ------------------------------- -------------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ------------------------------- -------------------------------- ------------------------------- -------------------------------- ------------------------------- -------------------------------- Social Security or other Taxpayer Identification Number, if any --------------------------------------------------------------------

Appears in 1 contract

Samples: Purchase Contract Agreement (PPL Capital Funding Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Stock Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Normal Units evidenced by this Stripped Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:: _________________________ ____________________________________ Signature Signature Guarantee: Signature* If shares are to be registered in the REGISTERED HOLDER name of and delivered REGISTERED HOLDER to a Person other than the Holder, please print Please print name and address of such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ ________________________________ ___________________________________ Name Name --------------------------------- ------------------------------------ ________________________________ ___________________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ________________________________ ___________________________________ Social Security or other Taxpayer Identification Number, if any ------------------------------------___________________________________ * Signature must be guaranteed by an eligible Guarantor Institution (banks, stockbrokers, savings and loan associations and credit unions) with membership in an approved signature medallion program pursuant to Securities and Exchange Commission Rule 17Ad-15 if Common Stock is to be delivered other than to, and in the name of, the registered Holder.

Appears in 1 contract

Samples: Master Unit Agreement (Amerus Life Holdings Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after an Acceleration Date or the Purchase Contract Final Settlement Date of the Purchase Contracts underlying the number of Stripped Units Securities evidenced by this Stripped Unit Security Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:________________________ ___________________________ Signature If shares are to be registered in the REGISTERED HOLDER name of and delivered to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: ______________________________ Signature Signature Guarantee: If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ ___________________________ Name Name --------------------------------- ------------------------------------ ______________________________ ___________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any ------------------------------------___________________________

Appears in 1 contract

Samples: Purchase Contract Agreement (Household International Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Units Income PRIDES evidenced by this Stripped Unit Income PRIDES Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : ----------------- ------------------------------ Signature [Signature Guarantee: guarantee (if assigned to another person)] If shares are to be registered in the name of and delivered to REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ -------------------------------- ------------------------------ Name Name --------------------------------- ------------------------------------ -------------------------------- ------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any -------------------------------------------------------------------- ------------------------------ -------------------------------- ------------------------------ -------------------------------- ------------------------------

Appears in 1 contract

Samples: Purchase Contract Agreement (Conseco Financing Trust Vii)

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SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Units Corporate MEDS evidenced by this Stripped Unit Corporate MEDS Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_________________________ __________________________________________ Signature Signature Guarantee: _____________________ (if assigned to another person) If shares are to be registered in the name of and delivered to REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and address: Please print name and address of name and address and (ii) provide Registered Holder: --------------------------------- ------------------------------------ a guarantee of your signature: ______________________________ __________________________________________ Name Name --------------------------------- ------------------------------------ ______________________________ __________________________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ______________________________ __________________________________________ ______________________________ __________________________________________ ______________________________ __________________________________________ Social Security or other Taxpayer Identification Number, if any ------------------------------------__________________________________________

Appears in 1 contract

Samples: Purchase Contract Agreement (Keyspan Corp)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying relating to the number of Stripped Units Corporate PIES evidenced by this Stripped Unit Corporate PIES Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will agrees to pay any transfer tax payable incident thereto. Dated:: _______________________ _____________________________________ Signature Signature Guarantee:_________________ (if assigned to another person) REGISTERED HOLDER Please print name and address of Registered Holder: ________________________________________________________________________________ (insert name) ________________________________________________________________________________ (insert address) ________________________________________________________________________________ ________________________________________________________________________________ (insert social security or other taxpayer identification number, if any) _____________________________________ If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your signature: ________________________________________________________________________________ (insert name) ________________________________________________________________________________ (insert address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security ) ________________________________________________________________________________ ________________________________________________________________________________ (insert social security or other Taxpayer Identification Numbertaxpayer identification number, if any ------------------------------------any)

Appears in 1 contract

Samples: Purchase Contract Agreement (Sierra Pacific Resources /Nv/)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying relating to the number of Stripped Corporate Units evidenced by this Stripped Corporate Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will agrees to pay any transfer tax payable incident thereto. Dated:: _______________________ _____________________________________ Signature Signature Guarantee: (if assigned to another person) REGISTERED HOLDER Please print name and address of Registered Holder: ------------------------------------------------------------------------------- (insert name) ------------------------------------------------------------------------------- (insert address) ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- (insert social security or other taxpayer identification number, if any) ------------------------------------- If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your signature: ------------------------------------------------------------------------------- (insert name) ------------------------------------------------------------------------------- (insert address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security ) ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- (insert social security or other Taxpayer Identification Numbertaxpayer identification number, if any ------------------------------------any)

Appears in 1 contract

Samples: Purchase Contract Agreement (Dqe Capital Corp)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Corporate Units evidenced by this Stripped Corporate Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:: _______________________ _______________________________ Signature Signature Guarantee: _______________________________ Signature Signature Guarantee: (if assigned to another person) If shares are to be registered in the name of and delivered to REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ _______________________________ _______________________________ Name Name --------------------------------- ------------------------------------ _______________________________ _______________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any ------------------------------------Address

Appears in 1 contract

Samples: Purchase Contract Agreement (Nisource Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Final Settlement Date of the Purchase Contracts underlying the number of Stripped Units Securities evidenced by this Stripped Unit Security Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : ----------------------------- ------------------------------- Signature Signature Guarantee: If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the REGISTERED HOLDER Holder, please print such Person's name and address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ ------------------------------- Name Name --------------------------------- ------------------------------------ ------------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any -------------------------------------------------------------------

Appears in 1 contract

Samples: Purchase Contract Agreement (Medpartners Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped PEPS Units evidenced by this Stripped Unit PEPS Units Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : --------------------------------- ------------------------------------ Signature Signature Guarantee: ---------------- (if assigned to another person) If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other REGISTERED HOLDER than the Holder, please (i) print such Person's name and address: address and (ii) Please print name and address of provide a guarantee of your signature: Registered Holder: --------------------------------- --------------------------------------- ------------------------------------ Name Name --------------------------------- --------------------------------------- ------------------------------------ Address Address --------------------------------- --------------------------------------- ------------------------------------ --------------------------------- --------------------------------------- ------------------------------------ --------------------------------- --------------------------------------- ------------------------------------ Social Security or other Taxpayer Identification Number, if any ------------------------------------

Appears in 1 contract

Samples: Purchase Contract Agreement (Valero Energy Corp/Tx)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock and CPR Certificates deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Units Corporate PIES evidenced by this Stripped Unit Corporate PIES Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:: _______________________ _____________________________________ Signature Signature Guarantee: ________________ (if assigned to another person) If shares or CPR Certificates are to be registered in the name of and delivered REGISTERED HOLDER to a Person REGISTERED HOLDER other than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ ------------------------------------- ------------------------------------- Name Name --------------------------------- ------------------------------------ ------------------------------------- ------------------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ ------------------------------------- ------------------------------------- ------------------------------------- ------------------------------------- ------------------------------------- ------------------------------------- Social Security or other Taxpayer Identification _____________________________________ Number, if any ------------------------------------any

Appears in 1 contract

Samples: Purchase Contract Agreement (Washington Mutual Inc)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Stock Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Normal Units evidenced by this Stripped Unit Normal Units Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:_______________________ ____________________________________ : -------------------- -------------------------------------- Signature Signature Guarantee: (if assigned to another person) ------------------ If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ -------------------------------------------------------------------------------- Name Name --------------------------------- ------------------------------------ -------------------------------------------------------------------------------- Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Social Security or other Taxpayer Identification Number, if any ------------------------------------REGISTERED HOLDER Please print name and address of Registered Holder: -------------------------------------------------------------------------------- Name -------------------------------------------------------------------------------- Address -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- --------------------------------------------------------------------------------

Appears in 1 contract

Samples: Purchase Contract Agreement (Metlife Capital Trust I)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying relating to the number of Stripped Units Corporate PIES evidenced by this Stripped Unit Corporate PIES Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will agrees to pay any transfer tax payable incident thereto. Dated:: _______________________ _____________________________________ Signature Signature Guarantee:_________________ (if assigned to another person) REGISTERED HOLDER Please print name and address of Registered Holder: ________________________________________________________________________________ (insert name) ________________________________________________________________________________ (insert address) ________________________________________________________________________________ ________________________________________________________________________________ (insert social security or other taxpayer identification number, if any) ________________________________ If shares are to be registered in the name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and address and (ii) provide a guarantee of your signature: ________________________________________________________________________________ (insert name) ________________________________________________________________________________ (insert address: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ Name Name --------------------------------- ------------------------------------ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ Social Security ) ________________________________________________________________________________ ________________________________________________________________________________ (insert social security or other Taxpayer Identification Numbertaxpayer identification number, if any ------------------------------------any)

Appears in 1 contract

Samples: Purchase Contract Agreement (Sierra Pacific Resources /Nv/)

SETTLEMENT INSTRUCTIONS. The undersigned Holder directs that a certificate for shares of Common Stock deliverable upon settlement on or after the Purchase Contract Settlement Date of the Purchase Contracts underlying the number of Stripped Corporate Units evidenced by this Stripped Corporate Unit Certificate be registered in the name of, and delivered, together with a check in payment for any fractional share, to the undersigned at the address indicated below unless a different name and address have been indicated below. If shares are to be registered in the name of a Person other than the undersigned, the undersigned will pay any transfer tax payable incident thereto. Dated:: _______________________ ______________________________________ Signature Signature Guarantee: _________________ (if assigned to another person) If shares are to be registered in the REGISTERED HOLDER name of and delivered REGISTERED HOLDER to a Person other than the Holder, please (i) print such Person's name and addressaddress and (ii) provide a guarantee of your signature: Please print name and address of Registered Holder: --------------------------------- ------------------------------------ _____________________________________ ______________________________________ Name Name --------------------------------- ------------------------------------ _____________________________________ ______________________________________ Address Address --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ --------------------------------- ------------------------------------ _____________________________________ ______________________________________ _____________________________________ ______________________________________ _____________________________________ ______________________________________ Social Security or other Taxpayer Identification _____________________________________ Number, if any ------------------------------------any

Appears in 1 contract

Samples: Purchase Contract Agreement (Dominion Resources Inc /Va/)

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