Notice of Intent to Exercise Conversion Right
EXHIBIT 4.3
Notice of Intent to Exercise Conversion Right
June __, 2005
VillageEDOCS
00000 Xxxxxxxx Xxxx, Xxx. 000
Xxxxxx, XX 00000
Attn: Corporate Secretary
Dear Sir:
Pursuant to Section 3(a) of that certain Promissory Note Modification Agreement dated June ___, 2005 (the "Agreement") by and between the undersigned and VillageEDOCS, a California corporation (the "Company"), the undersigned, with respect to $________ in unpaid principal on all outstanding convertible promissory notes held by the undersigned, hereby elects to exercise the conversion right granted thereby to acquire ______________ shares of the common stock of the Company at $0.10 per share.
The undersigned represents and warrants to the Company that the undersigned is acquiring the shares for investment only and not with a view to distribution or resale except for transactions on the public market in accordance with applicable law.
Dated: _____________ ______________________________
_______________________________
Print
Name
Acknowledgment
VillageEDOCS
By:
_________________________________ ________________________
X. Xxxxx Xxxxxx Date
President and Chief Executive Officer