EXHIBIT 99.12
RHYTHMS NETCONNECTIONS INC.
1999 EMPLOYEE STOCK PURCHASE PLAN ("ESPP")
ENROLLMENT/CHANGE FORM
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SECTION 1:
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ACTION COMPLETE SECTIONS:
/ / New Enrollment 2, 3, 7 and sign attached Stock Purchase Agreement
ACTIONS / / Payroll Deduction Change 2, 4, 7
/ / Terminate Payroll Deductions 2, 5, 7
/ / Leave of Absence 2, 6, 7
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SECTION 2:
------------------ Name
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Last First MI Dept.
PERSONNEL DATA Home Address
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Street
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City State Zip Code
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Social Security # - -
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SECTION 3:
------------------ Effective with the Purchase Payroll Deduction Amount: _______ % of cash earnings*
Interval Beginning:
NEW ENROLLMENT / / First Business Day of May, _______
* Must be a multiple of 1% up to a maximum of
/ / First Business Day of November, _______ 15% of cash earnings
/ / Initial Offering Period
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SECTION 4:
------------------ Effective with the I authorize the following new level of payroll
PAYROLL Pay Period Beginning: __________________________ deduction: __________% of cash earnings*
DEDUCTION Month, Day and Year
CHANGE * Must be a multiple of 1% up to a maximum
of 15% of cash earnings
NOTE: You may reduce your rate of payroll deductions once per 6-month purchase interval to become
effective as soon as possible following the filing of the change form. You may also increase
your rate of payroll deductions to become effective as of the start date of the next
6-month interval (first business day of May or November).
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SECTION 5:
------------------ Effective with the Your election to terminate your payroll
TERMINATE Pay Period Beginning: __________________________ deductions for the balance of the offering
PAYROLL Month, Day and Year period cannot be changed, and you may not
DEDUCTIONS rejoin the offering period at a later date.
You will not be able to resume participation
in the ESPP until the start of the next
offering period.
In connection with my voluntary termination of payroll deductions, I elect the following action
regarding my ESPP payroll deductions to date in the current purchase interval:
/ / Purchase shares of Rhythms NetConnections Inc. at the end of the purchase interval
OR
/ / Refund ESPP payroll deductions collected
NOTE: If your employment terminates for any reason or your eligibility status changes (LESS THAN
20 hrs/week or LESS THAN 5 months/year), you will immediately cease to participate in the ESPP,
and your ESPP payroll deductions collected in that purchase interval will automatically be
refunded to you.
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SECTION 6: In connection with my leave of absence, I elect the following action with respect to my ESPP payroll
------------------ deductions to date in the current purchase interval:
LEAVE OF ABSENCE / / Purchase shares of Rhythms NetConnections Inc. at the end of the purchase interval
OR
/ / Refund ESPP payroll deductions collected
NOTE: If you take an unpaid leave of absence, your payroll deductions will immediately cease.
If you return to active status within 90 days after the start of your leave, your
payroll deductions will at that time automatically resume at the rate in effect
for you when your leave began.
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SECTION 7:
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AUTHORIZATION I hereby authorize the specific action or actions indicated above.
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Date Signature of Employee
