Exhibit 4.3
June __, 1998
FiberChem, Inc.
0000 Xxxxx Xxxxx
Xxxxx X
Xxx Xxxxx, Xxxxxx 00000
Dear Xxx or Madame:
The undersigned, a holder of options and/or warrants to purchase Common
Stock of FiberChem, Inc. (the "Company") understands that the Company intends to
grant rights (the "Rights") to purchase units (the "Units") consisting of one
share of the Company's common stock (the "Common Stock") and one Class E Common
Stock Purchase Warrant ("Class E Warrant") to the Company's securityholders of
record on the record date. If all the rights are exercised, the Company will
not have sufficient shares of Common Stock authorized to meet all of its
obligations. Therefore, the Company intends to seek shareholder approval at the
1998 Annual Shareholder Meeting scheduled for July 22, 1998, to amend the
Company's Certificate of Incorporation to increase the number of shares of
Common Stock which are authorized.
The undersigned agrees, for the benefit of the Company, that the
undersigned will not exercise any options or warrants currently granted or
subsequently granted prior to the time that the Company has sufficient shares of
Common Stock authorized to meet all of its obligations.
Very truly yours,
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Printed Name
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Signature
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If the signatory is an entity, print
name and title of individual signing
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Options and/or Warrants
Please indicate the number of shares of
Common Stock issuable upon the exercise
of options or warrants or other derivative
securities.
