Special Payment Instructions. (If applicable—see item 4 of Instructions) To be completed ONLY if cash payments are to be mailed to a recipient OTHER than the registered holder(s). Stock must be properly assigned and signatures guaranteed. For additional payment instructions, please attach additional sheet. Mail cash payments to (please print): Name: Address: (Zip Code) * The Medallion Signature Guarantee, above, must also be completed if you designate Special Payment Instructions.
Special Payment Instructions. Indicate any particulars, special instructions or references to facilitate payment or identification of payment.
Special Payment Instructions. If checks or certificates representing Provident Financial Services, Inc. common stock are to be payable to the order of or registered is other than exactly the name(s) that appear(s) on the certificate(s) representing shares of First Sentinel Bancorp, Inc. common stock being submitted herewith, the certificate(s) submitted herewith must be endorsed, or accompanied by appropriate signed stock power(s), and the signature(s) appearing on such endorsement(s) or stock power(s) and on this Election Form 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. Please also check the appropriate box in “Special Payment Instructions” on the Election Form.
Special Payment Instructions. Provide new payee information in Box D if different than those listed in Box C. A Medallion Guarantee is required. Please see Instruction No.
Special Payment Instructions. Provide new payee information in Box C if different than listed on page 2 of this Letter of Transmittal. A Medallion Guarantee is required. Please see Instruction No.
Special Payment Instructions. Complete Box C only if payment is to be issued in the name of someone other than the registered holder. If you complete this box you will need a Medallion Signature Guarantee by an eligible institution (see instructions). In addition, depending on the circumstances of the payment, you may be requested to provide additional supporting documentation such as a certified copy of a trust agreement, corporate board resolutions, incumbency certificate or articles of association, as applicable. Do you want your aggregate Per Share Net Merger Consideration to be sent by electronic transfer or check?
Special Payment Instructions. (If applicable — See Instructions B(2) and B(3)) (If applicable – See Instruction B(4)) Signature Date
Special Payment Instructions. If checks or certificates representing Oak Hill common stock are to be payable to the order of or registered in other than exactly the name(s) that appear(s) on the certificate(s) representing shares of Lxxxxxxx common stock being submitted herewith, the certificate(s) submitted herewith must be endorsed, or accompanied by appropriate signed stock power(s), and the signature(s) appearing on such endorsement(s) or stock power(s) and on this Election Form and Letter of Transmittal 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. Please also check the appropriate box in “Special Payment Instructions” on the Election Form and Letter of Transmittal.
Special Payment Instructions. If check or certificates representing FirstBank common stock are to be payable to the order of or registered in other than exactly the name(s) that appear(s) on the certificate(s) representing shares of Oregon Trail common stock being submitted herewith, the certificate(s) submitted herewith must be endorsed, or accompanied by appropriate signed stock power(s), and the signature(s) appearing on such endorsement(s) or stock power(s) and on this Election Form and Letter of Transmittal 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. Please also check the appropriate box in "Special Payment Instructions" on the Election Form and Letter of Transmittal.
Special Payment Instructions. (SEE INSTRUCTIONS 1, 5, 6 AND 7) To be completed ONLY if the check for the purchase price of Shares purchased or certificates for Shares not tendered or not purchased are to be issued in the name of someone other than the undersigned, or if Shares tendered by book-entry transfer that are not purchased are to be returned by credit to an account at one of the Book-Entry Transfer Facilities other than that designated above. Issue check and/or certificates to: Name ___________________________________________________________________________ (Please Print) Address ________________________________________________________________________ ________________________________________________________________________ (Taxpayer Identification No.) (See Substitute Form W-9) / / Credit unpurchased Shares tendered by book-entry transfer to the account set forth below: Name of Account Party __________________________________________________________ Account No. at ____________________________________________________________________ / / The Depository Trust Company / / Midwest Securities Trust Company / / Philadelphia Depository Trust Company SPECIAL DELIVERY INSTRUCTIONS (SEE INSTRUCTIONS 1, 5, 6 AND 7) To be completed ONLY if the check for the purchase price of Shares purchased or certificates for Shares not tendered or not purchased are to be mailed to someone other than the undersigned or to the undersigned at an address other than that shown below the undersigned's signature(s). Mail check and/or certificates to: Name ___________________________________________________________________________ Address ________________________________________________________________________ ________________________________________________________________________ (Taxpayer Identification No.) FORMING PART OF THE TERMS AND CONDITIONS OF THE OFFER
