Dear Shareholder:
Exhibit 99(c)
Dear Shareholder:
The enclosed Election Form and Form W-9 is being sent to you in connection with the
Agreement of Reorganization and Merger, dated as of September 2, 2008 (the “Merger Agreement”), by and between First Merchants Corporation (“First Merchants”) and Lincoln Bancorp (“Lincoln”), pursuant to which,
subject to the approval of Lincoln’s shareholders and the fulfillment of certain conditions, Lincoln will be merged with and into First Merchants. As a Lincoln shareholder, you have been asked to elect the form of merger consideration you wish
to receive upon the completion of the merger and to send to the Election Agent the enclosed Election Form in accordance with the terms thereof. The proxy statement-prospectus related to the merger which was sent to you separately contains a more
detailed description of the merger and the electio
n decision you are being asked to make.
It is important that you complete, execute and return the enclosed Election Form and Form W-9 to American Stock Transfer & Trust Company, LLC on or before , 2008.
If you have any questions about this Election Form, please contact either First Merchants Corporation, Attn: Xxxxxxx X. Xxxxxxx, 000 Xxxx Xxxxxxx Xxxxxx, Xxxxxx, Xxxxxxx 00000, (000) 000-0000, or Lincoln Bancorp, Attn: Xxxx X. Xxxx, 000 Xxxxxxxxxx Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000, (000) 000-0000.
Sincerely,
Xxxxx X. Xxxxx
Ex. 99(c)-1
Exhibit 99(c)
ELECTION FORM
Mail or deliver by hand or courier this Election Form to American Stock Transfer & Trust Company, LLC, the Election Agent for the merger:
If delivering by mail:
American Stock Transfer & Trust Company, LLC Operations Center Attn: Reorganization Department X.X. Xxx 0000 Xxx Xxxx, Xxx Xxxx 00000-0000 |
If delivering by hand or courier:
American Stock Transfer & Trust Company, LLC Operations Center Attn: Reorganization Department 0000 00xx Xxxxxx Xxxxxxxx, Xxx Xxxx 00000 |
Delivery shall be effected only upon proper delivery of this Election Form. The method you choose to deliver this Election Form is at your option and risk. Delivery to an address other than as set forth above does not constitute a valid delivery.
In connection with the Agreement of Reorganization and Merger, dated as of September 2, 2008 (the “Merger Agreement”), by and between First Merchants Corporation (“First Merchants”) and Lincoln Bancorp (“Lincoln”), pursuant to which, subject to the fulfillment of certain conditions, Lincoln will be merged with and into First Merchants, you have been asked to elect the form of merger consideration you wish to receive upon the completion of the merger and to send to the Election Agent this Election Form in accordance with the terms hereof.
Holders of Lincoln common stock are being given the opportunity to elect the form of consideration to be received by them in the merger. For a full discussion of the merger and the effect of this election and the possible proration of the merger consideration to be paid to holders of Lincoln common stock, see the proxy statement-prospectus, dated , 2008 (the “Proxy Statement-Prospectus”), and the Merger Agreement, which is attached thereto as Appendix A. If you have any questions about this Election Form, please contact either First Merchants Corporation, Attn: Xxxxxxx X. Xxxxxxx, 000 Xxxx Xxxxxxx Xxxxxx, Xxxxxx, Xxxxxxx 00000, (000) 000-0000, or Lincoln Bancorp, Attn: Xxxx X. Xxxx, 000 Xxxxxxxxxx Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000, (000) 000-0000.
This election governs the consideration that you, as a holder of Lincoln common stock, will receive if the merger is approved and consummated. This election may also affect the income tax treatment of the consideration that you receive.
Ex. 99(c)-2
Exhibit 99(c)
In order to make an election to receive either (i) 0.7004 shares of First Merchants common stock (the “Share Option”), subject to possible upward or downward adjustment as provided in the Merger Agreement, or (ii) $15.76 in cash (the “Cash Option”) for each Lincoln common share, you should complete Section A by checking the appropriate option. You may elect the Share Option for all of your Lincoln common shares, the Cash Option for all of your Lincoln common shares, or a combination of the Share Option for a portion of your Lincoln common shares and the Cash Option for a portion of your Lincoln common shares. For each option, you must specifically indicate in the blank provided by each option the number of your Lincoln common shares for which you wish to elect either the Share Option or the Cash Option. The number of shares of First Merchants common stock and the amount of cash payable in connection with the merger is subject to various limitations and prorations. Under certain circumstances, an election to receive the Share Option or the Cash Option may be converted into an election to receive the other type of consideration. Failure to indicate the number of shares for which you wish to elect either the Share Option or the Cash Option will result in an invalid election and will be treated as if you elected the Share Option for all shares you own. If you fail to make an election, you will be considered to have elected to receive the Share Option for your Lincoln shares, but if it is necessary to convert some Share Option elections to Cash Option elections under the proration provisions of the Merger Agreement, Lincoln shares for which no election was made will be the first to be changed from receiving the Share Option to receiving the Cash Option.
If you elect the Share Option and the application of the 0.7004 conversion ratio to your Lincoln common shares results in fractional shares of First Merchants common stock, you will receive cash for the fractional shares. No fractional shares of First Merchants common stock will be issued to Lincoln shareholders. The price of the fractional shares for which you will receive cash will equal the average of the closing price of the common stock of First Merchants as reported by Bloomberg, L.P. for the twenty (20) NASDAQ trading days preceding the fifth (5th) calendar day prior to the closing date of the merger of Lincoln into First Merchants pursuant to the Merger Agreement.
The 0.7004 conversion ratio is subject to possible upward or downward adjustment as described in the Merger Agreement and the Proxy Statement-Prospectus.
In the event the Share Option and Cash Option elections submitted by Lincoln shareholders would entitle Lincoln’s shareholders to receive in the aggregate 3,576,417 or less shares of First Merchants common stock and $16,800,000 or less in cash, all valid Share Options elections and Cash Option elections of Lincoln shareholders shall be honored. In the event: (i) the Share Option elections would entitle Lincoln shareholders to receive in the aggregate more than 3,576,417 shares of First Merchants’ common stock; (ii) the Cash Option elections would entitle Lincoln shareholders to receive more than $16,800,000 in cash or (iii) the merger would not satisfy the “continuity of interest” rule applicable to tax-free reorganizations under the Internal Revenue Code of 1986, as amended (Continuity of Interest Rule), due to the amount of stock or cash that would be issuable in connection with the merger, certain of the Cash Option elections of the Lincoln shareholders may be converted into Share Option elections or certain of the Share Option elections of the Lincoln shareholders may be converted into Cash Option elections, as applicable.
In the event the Cash Option elections would entitle Lincoln shareholders to receive more than $16,800,000 in cash, the Cash Option elections will be converted to Share Option elections on a pro rata basis based on the number of Cash Option elections made by each shareholder (including the Lincoln ESOP only in limited circumstances as described below), but only to the extent necessary so that the total remaining number of Lincoln common shares covered by the Cash Option elections is such that the merger will result in cash payments of less than $16,800,000 in the aggregate and will satisfy the Continuity of Interest Rule. As a result of such provisions, certain Lincoln shareholders may receive less cash and more First Merchants common stock for their shares than they elected based on the choices made by the other Lincoln shareholders.
In the event the Share Option elections would entitle Lincoln shareholders to receive more than 3,576,417 shares of First Merchants common stock, all shares as to which no valid election was made (and which absent proration would be treated the same as Share Option elections) will be converted to Cash Option elections on a pro rata basis and, after all such shares are converted, the Share Option elections will be converted to Cash Option elections on a pro rata basis based on the number of Share Option elections made by each shareholder (including the Lincoln ESOP only in limited circumstances as described below), but only to the extent necessary so that the total remaining number of Lincoln common shares covered by the Share Option elections (and the non-elections, to the extent they are not all converted to Cash Option elections) is such that the merger will result in approximately 3,576,417 shares of First Merchants common stock being issued in connection with the merger and will satisfy the Continuity of Interest Rule. As a result of such provisions, certain Lincoln shareholders may receive less First Merchants common stock and more cash for their shares than they elected, and non-electing shareholders may receive a portion of their payment in cash, based on the choices made by the other Lincoln shareholders.
To be effective, this Election Form must be properly completed, signed and delivered to the Election Agent at the address above not later than 5:00 p.m., Eastern Time, on , 2008 (the “Election Deadline”). We have enclosed a pre-addressed envelope for your convenience. Please allow ample time for delivery.
Lincoln common shares for which an Election Form is not timely received or ever received or which are otherwise invalid elections will be treated as if the holder elected the Share Option for all shares owned. First Merchants and the Election Agent shall determine the validity of elections submitted by holders of Lincoln common stock. You will receive consideration for shares only upon the completion of the merger and your subsequent surrender of the certificate(s) representing such shares as instructed by First Merchants in a letter of transmittal to be mailed to each Lincoln shareholder of record following completion of the merger.
Ex. 99(c)-3
Completing and returning this Election Form does not have the effect of casting a vote with respect to the adoption of the Merger Agreement at the Special Meeting of Lincoln shareholders. In order to vote on the Merger Agreement, you should complete, sign and return the proxy card delivered with the Proxy Statement-Prospectus or vote in person at the Special Meeting of Lincoln shareholders.
ELECTION | ||
I hereby elect to receive the following as consideration for my shares of Lincoln common stock. I understand that a holder who fails to make an election will be deemed to have elected the Share Option with respect to his or her shares. | ||
¨ CASH OPTION | ||
|
shares of Lincoln common stock converted into cash payment of $15.76 per share of Lincoln common stock (subject to proration as described herein and in the Merger Agreement and Proxy Statement-Prospectus). | |
(insert number) | ||
¨ SHARE OPTION | ||
|
shares of Lincoln common stock converted into 0.7004 shares of First Merchants common stock per share of Lincoln common stock (subject to adjustment and proration as described herein and in the Merger Agreement and Proxy Statement-Prospectus). | |
(insert number) |
Ex. 99(c)-4
IMPORTANT TAX INFORMATION
Under the Federal income tax law, a non-exempt shareholder is required to provide the Election Agent with such shareholder’s correct Taxpayer Identification Number (“TIN”) on the Form W-9 included herein. If the certificate(s) are in more than one name or are not in the name of the actual owner, consult the enclosed Form W-9 instructions for additional guidance on which number to report. Failure to provide the information on the form may subject the surrendering shareholder to 28% federal backup withholding tax on the payment of any cash. If the Election Agent is not provided with a TIN before payment is made, the Election Agent will withhold 28% on all payments to such surrendering shareholders of any cash consideration due for their former shares. Please review the enclosed instructions to Form W-9 for additional details on what Taxpayer Identification Number to give the Election Agent.
To prevent backup withholding, holders that are not United States Holders should (i) submit a properly completed IRS Form W-8BEN, or other applicable form, to the Election Agent, certifying under penalties of perjury to the holder’s foreign status or (ii) otherwise establish an exemption. IRS Forms W-8BEN, or other applicable form, may be obtained from the Election Agent.
Certain holders (including, among others, corporations and certain foreign holders) are exempt recipients not subject to these backup withholding requirements. To avoid possible erroneous backup withholding, exempt United States Holders, while not required to file Form W-9, should complete and return the Form W-9.
For purposes of these instructions, a “United States Holder” is (i) an individual who is a citizen or resident alien of the United States, (ii) a corporation (including an entity taxable as a corporation) or partnership created or organized under the laws of the United States or of any political subdivision thereof, (iii) an estate the income of which is subject to United States federal income tax regardless of its source or (iv) a trust if (a) a court within the United States is able to exercise primary supervision over the administration of the trust and one or more United States persons have the authority to control all substantial decisions of the trust or (b) the trust has a valid election in effect under applicable Treasury regulations to be treated as a U.S. person.
See the enclosed instructions to Form W-9 for additional information and instructions.
TO ENSURE COMPLIANCE WITH TREASURY DEPARTMENT CIRCULAR 230, YOU ARE HEREBY NOTIFIED THAT: (A) ANY FEDERAL TAX ADVICE CONTAINED HEREIN IS NOT INTENDED OR WRITTEN TO BE USED, AND CANNOT BE USED BY ANY TAXPAYER FOR THE PURPOSE OF AVOIDING PENALTIES THAT MAY BE IMPOSED UNDER THE INTERNAL REVENUE CODE; (B) THE ADVICE IS WRITTEN IN CONNECTION WITH THE PROMOTION OR MARKETING OF THE TRANSACTION OR THE MATTERS ADDRESSED HEREIN; AND (C) THE TAXPAYER SHOULD SEEK ADVICE BASED ON THE TAXPAYER’S PARTICULAR CIRCUMSTANCES FROM AN INDEPENDENT TAX ADVISOR.
Ex. 99(c)-5
INSTRUCTIONS
TO
ELECTION FORM
Please follow these instructions carefully when completing this Election Form.
1. | ELECTION DEADLINE. To be effective, a properly completed Election Form must be received by the Election Agent not later than 5:00 p.m., Eastern Time, on the Election Deadline. Holders of Lincoln common stock whose Election Forms are not properly submitted by the Election Deadline (or who revoke their Election Forms, unless a contrary election is submitted by the holder within the period during which elections are permitted to be made) will be deemed to have elected the Share Option. See Instruction 4 below. |
2. | DESCRIPTION OF CERTIFICATES. Insert in the box on the Election Form the shareholder information requested. If this shareholder information is already provided in the box on the Election Form, confirm the information provided and make any necessary corrections. Insert in the box on the Election Form the certificate number(s) that represent your ownership of Lincoln shares and the number of shares of Lincoln common stock represented by each such certificate. If this certificate information is already provided in the box on the Election Form, confirm the information provided and make any necessary corrections. If the space provided in the box on the Election Form is insufficient, attach a separate sheet referencing the box on the first page of the Election Form and listing this information. |
3. | ELECTION OPTIONS. Please indicate on the Election Form whether you would like to receive in exchange for each share of your Lincoln common stock the Cash Option, the Share Option or some combination of both options. Note that the exact fraction of a share of First Merchants common stock and amount of cash you receive in exchange for each share of Lincoln common stock will be calculated using formulas stated in the Merger Agreement and described in the Proxy Statement-Prospectus. Please see the section entitled “The Merger—Exchange of Lincoln Common Shares” in the Proxy Statement-Prospectus for information about the allocation of consideration and the calculation of the conversion ratio. |
All elections made by Lincoln shareholders will be subject to reallocation and proration as described in the Merger Agreement and in the Proxy Statement-Prospectus if the available cash or the available First Merchants common stock is oversubscribed. As a result, we cannot assure you that you will receive the form of consideration that you elect to receive. Please see the section entitled “The Merger—Exchange of Lincoln Common Shares” in the Proxy Statement-Prospectus for information about possible prorations.
None of First Merchants, Lincoln, or the Election Agent makes any recommendation about whether a holder should elect to receive cash, First Merchants common stock, or a combination of First Merchants common stock and cash in the merger. Each holder must make his or her own decision about the election, bearing in mind the consideration received and the tax consequences of the election chosen.
4. | CHANGE OR REVOCATION OF ELECTION. A holder of Lincoln common stock who has made an election may, at any time before the Election Deadline, change the election by submitting a new Election Form, accompanied by a dated note stating that the new Election Form replaces the prior Election Form, in accordance with the procedures described herein, if received by the Election Agent before the Election Deadline, or revoke the holder’s election by providing written notice to the Election Agent by 5:00 p.m., Eastern Time, not later than the business day immediately before the Election Deadline. |
5. | NON-ELECTING STOCK. Holders of Lincoln common stock who fail to submit a properly completed Election Form by the Election Deadline, or who revoke their previously submitted Election Form without timely submitting a new Election Form, will be deemed to have made a “non-election.” Holders of Lincoln common stock who are deemed to have made a non-election will be deemed to have elected the Share Option in accordance with the terms of the Merger Agreement and the Proxy Statement-Prospectus. |
6. | FORM W-9. Please refer to the instructions accompanying the enclosed Form W-9 to determine if you are exempt from backup withholding and, if so, how to complete the Form W-9. All United States persons (including resident alien individuals) that elect the Cash Option must complete the Form W-9 and return it to the Election Agent at the address for delivery of the Election Form. Nonresident alien individuals and certain foreign entities that elect the Cash Option and are not subject to backup withholding or are subject to a reduced rate of backup withholding should complete the appropriate Form W-8 and return it to the Election Agent at the address for delivery of the Election Form before any cash payment is made by the Election Agent. An appropriate Form W-8 and its accompanying instructions may be obtained at any Internal Revenue Service office. FAILURE TO PROVIDE THE ELECTION AGENT BY THE TIME OF ANY CASH PAYMENT BY THE ELECTION AGENT A COMPLETED FORM W-9 MAY SUBJECT SUCH A SHAREHOLDER THAT ELECTS THE CASH OPTION TO 28% FEDERAL INCOME TAX BACKUP WITHHOLDING ON SUCH CASH PAYMENT BY THE ELECTION AGENT. |
7. | METHOD OF DELIVERY. The method of delivery of the Election Form is at the option and sole risk of the holder. Delivery of this Election Form will be effected only upon proper delivery of the Election Form to the Election Agent. If delivery is by mail, registered mail with return receipt requested, properly insured, or overnight delivery service is recommended. |
8. | DETERMINATIONS. All determinations concerning this Election Form, including determinations about the effectiveness of any elections or the computation of allocations, will be made by First Merchants and/or the Election Agent. First Merchants and/or the Election Agent shall have the right, in their sole and absolute discretion, to reject any and all Election Forms that are not in proper form and to waive any irregularities. Neither First Merchants nor the Election Agent is under any obligation to inform any holder of Lincoln common stock of any defect in an Election Form. |
9. | QUESTIONS. If you have questions regarding the Election Form, please contact either First Merchants Corporation, Attn: Xxxxxxx X. Xxxxxxx, 000 Xxxx Xxxxxxx Xxxxxx, Xxxxxx, Xxxxxxx 00000, (000) 000-0000, or Lincoln Bancorp, Attn: Xxxx X. Xxxx, 000 Xxxxxxxxxx Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000, (000) 000-0000. |
Ex. 99(c)-6
Print or type
See Specific Instructions on page 2.
Form W-9 (Rev. October 2007) Department of the Treasury Internal Revenue Service |
Request for Taxpayer Identification Number and Certification |
Give form to the requester. Do not |
Name (as shown on your income tax return)
Business name, if different from above
Check appropriate box: |
¨ | Individual/ Sole proprietor |
¨ | Corporation | ¨ | Partnership | ¨ | Exempt payee | ||||||||||||
¨ Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) u
¨ Other (see instructions) u |
Address (number, street, and apt. or suite no.)
Requester’s name and address (optional)
City, state, and ZIP code
List account number(s) here (optional)
Part I | Taxpayer Identification Number (TIN) |
Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. |
||||||||||||||||||
Social security number | ||||||||||||||||||
or | ||||||||||||||||||
Employer identification number | ||||||||||||||||||
Part II | Certification |
Under penalties of perjury, I certify that:
1. | The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and |
2. | I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and |
3. | I am a U.S. citizen or other U.S. person (defined below). |
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (XXX), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4.
Sign Here |
Signature of U.S. person u |
Date u |
Cat. No. 10231X |
Form W-9 (Rev. 10-2007) |
Form W-9 (Rev. 10-2007) |
Page 2 |
Form W-9 (Rev. 10-2007) |
Page 3 |
Form W-9 (Rev. 10-2007) |
Page 4 |
Form W-9 (Rev. 10-2007) |
Page 5 |
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an XXX, or Xxxxxx MSA or HSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S. possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism.
You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply.