Your Interest in the Registrable Securities. (a) State the type of Registrable Securities (Debentures or Common Stock) and the principal amount or number of such Registrable Securities beneficially owned by you. Check any of the following that applies to you. [ ] I own Debentures: Principal amount and CUSIP No. of the Debentures beneficially owned: ________________________________________________________________ CUSIP No(s): ___________________________________________________ [ ] I own shares of Common Stock that were issued upon conversion of the Debentures: Number of shares and CUSIP No. of the Common Stock beneficially owned: ____________________________________________ CUSIP No(s):____________________________________________________
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Samples: Registration Rights Agreement (Impax Laboratories Inc), Registration Rights Agreement (Impax Laboratories Inc)
Your Interest in the Registrable Securities. (a) State the type of Registrable Securities (Debentures Notes or Common Stock) and the principal amount or number of such Registrable Securities beneficially owned by you. Check any of the following that applies to you. [ ] I own DebenturesNotes: Principal amount and CUSIP No. of the Debentures Notes beneficially owned: ______________Principal Amount: __________________________________________________ CUSIP No(s): _______________________________________________________ [ ] I own shares of Common Stock that were issued upon conversion of the DebenturesNotes: Number of shares and CUSIP No. of the Common Stock beneficially owned: Number of shares: __________________________________________________ CUSIP No(s):): _______________________________________________________
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Your Interest in the Registrable Securities. (a) State the type of Registrable Securities (Debentures or Common Stock) and the principal amount or number of such Registrable Securities beneficially owned by you. Check any of the following that applies to you. [ ] ¨ I own Debentures: Principal amount and CUSIP No. of the Debentures beneficially owned: _________________________________________________________________________________________ CUSIP No(sNo.(s): _______________________________________________________________________________ [ ] ¨ I own shares of Common Stock that were issued upon conversion of the Debentures: Number of shares and CUSIP No. of the Common Stock beneficially owned: _________________________________________________________________________________________ CUSIP No(s):No.(s): _______________________________________________________________________________
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Your Interest in the Registrable Securities. (a) State the type of Registrable Securities (Debentures Notes or Common Stock) and the principal amount or number of such Registrable Securities beneficially owned by you. Check any of the following that applies to you. [ ] I own DebenturesNotes: Principal amount and CUSIP No. of the Debentures Notes beneficially owned: ______________________________________________________________________ CUSIP No(s): _________________________________________________________ [ ] I own shares of Common Stock that were issued upon conversion of the DebenturesNotes: Number of shares and CUSIP No. of the Common Stock beneficially owned: ____________________________________________ CUSIP No(s):): _________________________________________________________
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Samples: Registration Rights Agreement (Greenbrier Companies Inc)