WARRANT TO PURCHASE UP TO 54,000 SHARES OF COMMON STOCK
Exhibit 10.9
NEITHER THIS WARRANT NOR THE SECURITIES ISSUABLE UPON EXERCISE OF THIS WARRANT HAVE BEEN REGISTERED
UNDER THE SECURITIES ACT OF 1933, AS AMENDED. NO SALE OR DISPOSITION MAY BE EFFECTED EXCEPT IN
COMPLIANCE WITH RULE 144 UNDER SAID ACT OR WITHOUT AN EFFECTIVE REGISTRATION STATEMENT RELATED
THERETO OR AN OPINION OF COUNSEL FOR THE HOLDER, SATISFACTORY TO THE COMPANY, THAT SUCH
REGISTRATION IS NOT REQUIRED UNDER THE ACT OR RECEIPT OF A NO-ACTION LETTER FROM THE SECURITIES AND
EXCHANGE COMMISSION.
WARRANT TO PURCHASE UP TO 54,000 SHARES OF COMMON STOCK
September 25, 2003
THIS CERTIFIES THAT, for value received, General Electric Capital Corporation (“Holder”) is
entitled to subscribe for and purchase a number of shares of the fully paid and nonassessable
Common Stock of Compound Therapeutics, Inc., a Delaware corporation (the “Company”) determined
pursuant to Section 1(a) below (the “Shares” or the “Stock”), at the Warrant Price (as hereinafter
defined), subject to the provisions and upon the terms and conditions hereinafter set forth.
1. Number of Shares; Warrant Price.
(a) Number. Prior to June 30, 2004, this Warrant shall be exercisable for a maximum of
Forty-Four Thousand (44,000) shares of Common Stock. After June 30, 2004, this Warrant shall be
exercisable for a maximum of Fifty-Four Thousand (54,000) shares of Common Stock; provided,
however, that if, prior to June 30, 2004, General Electric Capital Corporation has not made
available to the Company an aggregate of $1,350,000 pursuant to that certain Loan Proposal, dated
June 16, 2003, from GE Capital to the Company, then the maximum number of shares of Common Stock
issuable upon exercise of this Warrant shall be Forty-Four Thousand (44,000).
(b) The Warrant Price shall initially be 75/100 dollars ($.75) per share, subject to adjustment as
provided in Section 7 below.
2. Conditions to Exercise. The purchase right represented by this Warrant may be
exercised at any time, or from time to time, in whole or in part during the term commencing on the
date hereof and ending at 5:00 P.M. Pacific time on the fifth anniversary of the date of this
Warrant.
3. Method of Exercise; Payment; Issuance of Shares; Issuance of New Warrant.
(a) Cash Exercise. Subject to Section 2 hereof, the purchase right represented by this
Warrant may be exercised by the Holder hereof, in whole or in part, by the surrender of this
Warrant (with a duly executed Notice of Exercise in the form attached hereto) at the principal
office of the Company (as set forth in Section 18 below) and by payment to the Company, by check,
of an amount equal to the then applicable Warrant Price per share multiplied by the number of
shares then being purchased. In the event of any exercise of the rights represented by this
Warrant, certificates for the shares of stock so purchased shall be in the name of, and delivered
to, the Holder hereof, or as such Holder may direct (subject to the terms of transfer contained herein and
upon payment by such Holder hereof of any applicable transfer taxes). Such delivery shall be
made
within 30 days after exercise of the Warrant and at the Company’s expense and, unless this Warrant
has been fully exercised or expired, a new Warrant having terms and conditions substantially
identical to this Warrant and representing the portion of the Shares, if any, with respect to which
this Warrant shall not have been exercised, shall also be issued to the Holder hereof within 30
days after exercise of the Warrant.
(b) Net Issue Exercise. Holder may also elect to receive shares equal to the value of
this Warrant (or of any portion thereof remaining unexercised) by surrender of this Warrant at the
principal office of the Company together with notice of such election, in which event the Company
shall issue to Holder the number of shares of the Company’s Common Stock computed using the
following formula:
Where X = the number of shares of Stock to be issued to Holder.
Y = the number of shares of Stock purchasable under this Warrant (at the date of such calculation),
or, if only a portion, the amount of stock for which the Warrant is being exchanged.
A = the Fair Market Value of one share of the Company’s Common Stock (at the date of such
calculation).
B = Warrant Price (as adjusted to the date of such calculation).
(c) Fair Market Value. For purposes of this Section 3, Fair Market Value of one share of
the Company’s Stock shall mean:
(i) In the event of an exercise in connection with an Initial Public Offering, the per share
Fair Market Value for the Stock shall be the Offering Price per share at which the
underwriters initially sell Common Stock to the public; or
(ii) In the event there is a public market for the trading of the Common Stock, the average
of the closing bid and asked prices of Common Stock quoted in the Over-The-Counter Market
Summary, the last reported sale price quoted on the Nasdaq National Market (“NNM”) or on any
exchange on which the Common Stock is listed, whichever is applicable, as published in the
Western Edition of the Wall Street Journal for the ten (10) consecutive trading days prior
to the date of exercise, multiplied by the number of shares of; or
(iii) In any other instance, the per share Fair Market Value for the Stock shall be deemed
to be the amount most recently determined in good faith by the Company’s Board of Directors
to represent the fair market value per share of the Common Stock (including without
limitation a determination for purposes of granting Common Stock options or issuing Common
Stock under any plan, agreement or arrangement with employees of the Company. In such
event, upon request of the Holder, the Company’s Board of Directors
(or a representative thereof) shall prepare a certificate, to be signed by an authorized
officer of the Company, setting forth in reasonable detail the basis for and method of
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determination of the per share Fair Market Value of the Stock. Such certification shall be
made to Holder not later than twenty (20) business days after such request.
(d) Automatic Exercise. To the extent this Warrant is not previously exercised, it shall
be automatically exercised in accordance with Sections
3(b) and 3(c) hereof (even if not surrendered) immediately before its expiration or cancellation.
3(b) and 3(c) hereof (even if not surrendered) immediately before its expiration or cancellation.
4. Representations and Warranties of Holder and the Company
(a) Representations and Warranties by Holder. The Holder represents and warrants to the Company
with respect to this purchase as follows:
(i) The Holder has substantial experience in evaluating and investing in private placement
transactions of securities of companies similar to the Company so that the Holder is capable
of evaluating the merits and risks of its investment in the Company and has the capacity to
protect its interests.
(ii) Except for transfers to a Holder’s affiliates, the Holder is acquiring the Warrant and
the Shares of Stock issuable upon exercise of the Warrant (collectively the “Securities”)
for investment for its own account and not with a view to, or for resale in connection with,
any distribution thereof. The Holder understands that the Securities have not been
registered under the Securities Act of 1933, as amended (the “Act”) by reason of a specific
exemption from the registration provisions of the Act which depends upon, among other
things, the bona fide nature of the investment intent as expressed herein.
(iii) The Holder acknowledges that the Securities must be held indefinitely unless
subsequently registered under the Act or an exemption from such registration is available.
The Holder is aware of the provisions of Rule 144 promulgated under the Act.
(iv) The Holder is an “accredited investor” within the meaning of Regulation D promulgated
under the Act.
(v) The Holder has had an opportunity to discuss the Company’s business, management and
financial affairs with its management and an opportunity to review the Company’s facilities.
(b) Company hereby represents and warrants to Holder that the statements in the following
paragraphs of this Section 4(b) are true and correct as of the date hereof.
(i) Corporate Organization and Authority. Company (a) is a corporation duly
organized, validly existing, and in good standing in its jurisdiction of incorporation, (b)
has the corporate power and authority to own and operate its properties and to carry on its
business as now conducted and as proposed to be conducted; and (c) is qualified as a foreign
corporation in all jurisdictions where such qualification is required.
(ii) Corporate Power. Company has all requisite legal and corporate power and
authority to execute, issue and deliver the Warrant, to issue the Common Stock issuable
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upon
exercise or conversion of the Warrant, and to carry out and perform its obligations under
the Warrant and any related agreements.
(iii) Authorization; Enforceability. All corporate action on the part of Company,
its officers, directors and shareholders necessary for the authorization, execution,
delivery and performance of its obligations under this Warrant and for the authorization,
issuance and delivery of the Warrant and Stock issuable upon exercise of the Warrant has
been taken and this Warrant constitutes the legally binding and valid obligation of Company
enforceable in accordance with its terms.
(iv) Valid Issuance of Warrant and Common Stock. The Warrant has been validly
issued and is free of restrictions on transfer other than restrictions on transfer set forth
herein and under applicable state and federal securities laws. The Common Stock issuable
upon conversion of this Warrant, when issued, sold and delivered in accordance with the
terms of this Warrant for the consideration expressed herein, will be duly and validly
issued, fully paid and nonassessable, and will be free of restrictions on transfer other
than restrictions on transfer under this Warrant and under applicable state and federal
securities laws. Subject to applicable restrictions on transfer, the issuance and delivery
of the Warrant and the Common Stock issuable upon conversion of the Warrant are not subject
to any preemptive or other similar rights or any liens or encumbrances except as
specifically set forth in Company’s Certificate of Incorporation or this Warrant. Based on
the representations made by the Holder in Section 4(a) above, the offer, sale and issuance
of the Warrant and Common Stock, as contemplated by this Warrant, are exempt from the
prospectus and registration requirements of applicable United States federal and state
security laws, and neither Company nor any authorized agent acting on its behalf has or will
take any action hereafter that would cause the loss of such exemption.
(v) No Conflict with Other Instruments. The execution, delivery, and performance of
this Warrant will not result in any violation of, be in conflict with, or constitute a
default under, with or without the passage of time or the giving of notice (a) any provision
of Company’s Certificate of Incorporation or by-laws; (b) any provision of any judgment,
decree, or order to which Company is a party or by which it is bound or an event which
results in the creation of any material lien, charge or encumbrance upon any material assets
of Company; (c) any contract, obligation, or commitment to which Company is a party or by
which it is bound; or (d) any statute, rule, or governmental regulation applicable to
Company.
(vi) Capitalization. As of recent date, the authorized capital stock of Company
consists of 27,999,998 shares of Common Stock, $.001 par value, of which 5,300,000 were
issued and outstanding, and 16,000,000 shares of Preferred Stock, .001 par value, of which
8,666,672 were issued and outstanding. The currently outstanding shares have been duly
authorized and validly issued (including, without limitation, issued in compliance with
applicable federal and state securities laws), are fully paid and
nonassessable. Company has reserved 54,000 shares of Common Stock for issuance upon
exercise of this Warrant.
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(vii) Governmental Consents. No consent, approval, order or authorization of, or
registration, qualification, designation, declaration or filing with, any federal, state or
local governmental authority on the part of Company is required in connection with the
offer, sale or issuance of the Warrant (and the Stock issuable upon the exercise of this
Warrant), or the consummation of any other transaction contemplated hereby, except for the
following: (a) the filing of a notice on Form D under the Act and b) the compliance with
other applicable state securities laws, which compliance will have occurred within the
appropriate time periods therefor.
5. Legends.
(a) Each certificate representing the Securities shall be endorsed with the following legend:
THESE SECURITIES HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT
OF 1933 AND MAY NOT BE TRANSFERRED UNLESS COVERED BY AN EFFECTIVE
REGISTRATION STATEMENT UNDER SAID ACT, A “NO ACTION” LETTER FROM THE
SECURITIES AND EXCHANGE COMMISSION WITH RESPECT TO SUCH TRANSFER, A
TRANSFER MEETING THE REQUIREMENTS OF RULE 144 OF THE SECURITIES AND
EXCHANGE COMMISSION, OR (IF REASONABLY REQUIRED BY THE COMPANY) AN
OPINION OF COUNSEL SATISFACTORY TO THE ISSUER TO THE EFFECT THAT ANY
SUCH TRANSFER IS EXEMPT FROM SUCH REGISTRATION.
The Company need not enter into its stock records a transfer of Securities unless the conditions
specified in the foregoing legend are satisfied. The Company may also instruct its transfer agent
not to allow the transfer of any of the Shares unless the conditions specified in the foregoing
legend are satisfied.
(b) Removal of Legend and Transfer Restrictions. The legend relating to the Act endorsed
on a certificate pursuant to paragraph 5(a) of this Warrant shall be removed and the Company shall
issue a certificate without such legend to the Holder of the Securities if (i) the Securities are
registered under the Act and a prospectus meeting the requirements of Section 10 of the Act is
available or (ii) the Holder provides to the Company an opinion of counsel for the Holder
reasonably satisfactory to the Company, a no-action letter or interpretive opinion of the staff of
the SEC reasonably satisfactory to the Company, or other evidence reasonably satisfactory to the
Company, to the effect that public sale, transfer or assignment of the Securities may be made
without registration and without compliance with any restriction such as Rule 144.
6. Condition of Transfer or Exercise of Warrant. It shall be a condition to any transfer
or exercise of this Warrant that at the time of such transfer or exercise, the Holder shall provide
the Company with a representation in writing that the Holder or transferee is acquiring this
Warrant
and the shares of Stock to be issued upon exercise for investment purposes only and not with a view
to any sale or distribution, or will provide the Company with a statement of pertinent facts
covering any proposed distribution. As a further condition to any transfer of this Warrant of any
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or all of the shares of Stock issuable upon exercise of this Warrant, other than a transfer
registered under the Act, the Company may request a legal opinion, in form and substance
satisfactory to the Company and its counsel, reciting the pertinent circumstances surrounding the
proposed transfer and stating that such transfer is exempt from the registration and prospectus
delivery requirements of the Act. The Company shall not require Holder to provide an opinion of
counsel if the transfer is to an affiliate of Holder. Each certificate evidencing the shares
issued upon exercise of the Warrant or upon any transfer of the shares (other than a transfer
registered under the Act or any subsequent transfer of shares so registered) shall, at the
Company’s option, if the Shares are not freely saleable under Rule 144(k) under the Act, contain a
legend in form and substance satisfactory to the Company and its counsel, restricting the transfer
of the shares to sales or other dispositions exempt from the requirements of the Act. As further
condition to each transfer, at the request of the Company, the Holder shall surrender this Warrant
to the Company and the transferee shall receive and accept a Warrant, of like tenor and date,
executed by the Company.
7. Adjustment for Certain Events. The number and kind of securities purchasable upon the
exercise of this Warrant and the Warrant Price shall be subject to adjustment from time to time
upon the occurrence of certain events, as follows:
(a) Reclassification or Merger. In case of any reclassification or change of securities
of the class issuable upon exercise of this Warrant (other than a change in par value, or from par
value to no par value, or from no par value to par value, or as a result of a subdivision or
combination), or in case of any merger of the Company with or into another corporation (other than
a merger with another corporation in which the Company is the acquiring and the surviving
corporation and which does not result in any reclassification or change of outstanding securities
issuable upon exercise of this Warrant), or in case of any sale of all or substantially all of the
assets of the Company, the Company, or such successor or purchasing corporation, as the case may
be, shall duly execute and deliver to the Holder a new Warrant (in form and substance satisfactory
to the Holder of this Warrant), or the Company shall make appropriate provision without the
issuance of a new Warrant, so that the Holder shall have the right to receive, at a total purchase
price not to exceed that payable upon the exercise of the unexercised portion of this Warrant, and
in lieu of the shares of Stock theretofore issuable upon exercise of this Warrant, the kind and
amount of shares of stock, other securities, money and property receivable upon such
reclassification, change, merger or sale by a Holder of the number of shares of Stock then
purchasable under this Warrant, or in the case of such a merger or sale in which the consideration
paid consists all or in part of assets other than securities of the successor or purchasing
corporation, at the option of the Holder, the securities of the successor or purchasing corporation
having a value at the time of the transaction equivalent to the value of the Stock purchasable upon
exercise of this Warrant at the time of the transaction. Any new Warrant shall provide for
adjustments that shall be as nearly equivalent as may be practicable to the adjustments provided
for in this Section 7. The provisions of this subparagraph (a) shall similarly apply to successive
reclassifications, changes, mergers and transfers.
(b) Subdivision or Combination of Shares. If the Company at any time while this Warrant
remains outstanding and unexpired shall subdivide or combine its outstanding shares of Common
Stock, the Warrant Price shall be proportionately decreased and the number of Shares issuable
hereunder shall be proportionately increased in the case of a subdivision and the Warrant Price
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shall be proportionately increased and the number of Shares issuable hereunder shall be
proportionately decreased in the case of a combination.
(c) Stock Dividends and Other Distributions. If the Company at any time while this
Warrant is outstanding and unexpired shall (i) pay a dividend with respect to Common Stock payable
in Common Stock, then the Warrant Price shall be adjusted, from and after the date of determination
of shareholders entitled to receive such dividend or distribution, to that price determined by
multiplying the Warrant Price in effect immediately prior to such date of determination by a
fraction (A) the numerator of which shall be the total number of shares of Common Stock issuable
upon exercise of this Warrant immediately prior to such dividend or distribution, and (B) the
denominator of which shall be the total number of shares of Common Stock issuable upon exercise of
this Warrant immediately after such dividend or distribution; or (ii) make any other distribution
with respect to Common Stock (except any distribution specifically provided for in Sections 7(a)
and 7(b)), then, in each such case, provision shall be made by the Company such that the Holder of
this Warrant shall receive upon exercise of this Warrant a proportionate share of any such dividend
or distribution as though it were the Holder of the Common Stock as of the record date fixed for
the determination of the shareholders of the Company entitled to receive such dividend or
distribution.
(d) Adjustment of Number of Shares. Upon each adjustment in the Warrant Price, the number
of Shares purchasable hereunder shall be adjusted, to the nearest whole share, to the product
obtained by multiplying the number of Shares purchasable immediately prior to such adjustment in
the Warrant Price by a fraction, the numerator of which shall be the Warrant Price immediately
prior to such adjustment and the denominator of which shall be the Warrant Price immediately
thereafter.
8. Notice of Adjustments. Whenever any Warrant Price or the kind or number of securities
issuable under this Warrant shall be adjusted pursuant to Section 7 hereof, the Company shall
prepare a certificate signed by an officer of the Company setting forth, in reasonable detail, the
event requiring the adjustment, the amount of the adjustment, the method by which such adjustment
was calculated, and the Warrant Price and number or kind of shares issuable upon exercise of the
Warrant after giving effect to such adjustment, and shall cause copies of such certificate to be
mailed (by certified or registered mail, return receipt required, postage prepaid) within thirty
(30) days of such adjustment to the Holder of this Warrant as set forth in Section 18 hereof.
9. Transferability of Warrant. This Warrant is transferable on the books of the Company
at its principal office by the registered Holder hereof upon surrender of this Warrant properly
endorsed, subject to compliance with Section 6 and applicable federal and state securities laws.
The Company shall issue and deliver to the transferee a new Warrant representing the Warrant so
transferred. Upon any partial transfer, the Company will issue and deliver to Holder a new Warrant
with respect to the Warrant not so transferred. Holder shall not have any right to transfer any
portion of this Warrant to any direct competitor of the Company.
10. Registration Rights; Agreement in Connection with Public Offering.
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(a) Investor Rights Agreement. The Holder shall become a party to the Investor Rights
Agreement, dated as of March 31, 2003, as amended from time to time, by and among the Company and
the other parties named therein, for purposes of providing “piggy-back” registration rights with
respect to the Shares.
(b) Lock-up. Holder agrees, in connection with the initial underwritten public offering
of the Company’s securities pursuant to a registration statement under the Act, (i) not to sell,
make short sale of, loan, grant any options for the purchase of, or otherwise dispose of any shares
of Common Stock held by Holder without the prior written consent of the Company or the underwriters
managing such initial underwritten public offering of the Company’s securities for a period of 180
days from the effective date of such registration statement, and (ii) to execute any agreement
reflecting clause (i) above as may be requested by the Company or the managing underwriters at the
time of such offering.
11. No Fractional Shares. No fractional share of Common Stock will be issued in
connection with any exercise hereunder, but in lieu of such fractional share the Company shall make
a cash payment therefor upon the basis of the Warrant Price then in effect.
12. Charges, Taxes and Expenses. Issuance of certificates for shares of Common Stock upon
the exercise of this Warrant shall be made without charge to the Holder for any United States or
state of the United States documentary stamp tax or other incidental expense with respect to the
issuance of such certificate, all of which taxes and expenses shall be paid by the Company, and
such certificates shall be issued in the name of the Holder.
13. No Shareholder Rights Until Exercise. This Warrant does not entitle the Holder hereof
to any voting rights or other rights as a shareholder of the Company prior to the exercise hereof.
14. Registry of Warrant. The Company shall maintain a registry showing the name and
address of the registered Holder of this Warrant. This Warrant may be surrendered for exchange or
exercise, in accordance with its terms, at such office or agency of the Company, and the Company
and Holder shall be entitled to rely in all respects, prior to written notice to the contrary, upon
such registry.
15. Loss, Theft, Destruction or Mutilation of Warrant. Upon receipt by the Company of
evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this
Warrant, and, in the case of loss, theft, or destruction, of indemnity reasonably satisfactory to
it, and, if mutilated, upon surrender and cancellation of this Warrant, the Company will execute
and deliver a new Warrant, having terms and conditions substantially identical to this Warrant, in
lieu hereof.
16. Miscellaneous.
(a) Issue Date. The provisions of this Warrant shall be construed and shall be given
effect in all respect as if it had been issued and delivered by the Company on the date hereof.
(b) Successors. This Warrant shall be binding upon any successors or assigns of the
Company.
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(c) Governing Law. This Warrant shall be governed by and construed in accordance with the
laws of the State of Delaware.
(d) Headings. The headings used in this Warrant are used for convenience only and are not
to be considered in construing or interpreting this Warrant.
(e) Saturdays, Sundays, Holidays. If the last or appointed day for the taking of any
action or the expiration of any right required or granted herein shall be a Saturday or a Sunday or
shall be a legal holiday in the State of Delaware, then such action may be taken or such right may
be exercised on the next succeeding day not a legal holiday.
(f) Waiver of Jury Trial. Each of the parties hereto hereby waives to the fullest extent
permitted by applicable law, any right it may have to a trial by jury in respect of any litigation
directly or indirectly arising out of, under or in connection with this Warrant or the Securities.
(g) Attorney’s Fees. In the event of any dispute between the parties concerning the terms
and provisions of this Warrant, the party prevailing in such dispute shall be entitled to collect
from the other party all costs incurred in such dispute, including reasonable attorney’s fees.
17. No Impairment. The Company will not, by amendment of its Certificate of Incorporation
or any other voluntary action, avoid or seek to avoid the observance or performance of any of the
terms of this Warrant, but will at all times in good faith assist in the carrying out of all such
terms and in the taking of all such action as may be necessary or appropriate in order to protect
the rights of the Holder hereof against impairment.
18. Addresses. Any notice required or permitted hereunder shall be in writing and shall
be mailed by overnight courier, registered or certified mail, return receipt required, and postage
prepaid, or otherwise delivered by hand or by messenger, addressed as set forth below, or at such
other address as the Company or the Holder hereof shall have furnished to the other party.
If to the Company: | Compound Therapeutics, Inc. | |||||
0000 Xxxx Xx. | ||||||
Xxxxxxx, XX 00000 | ||||||
Attn: Xx. Xxxxx Xxx | ||||||
If to the Holder: | General Electric Capital Corporation | |||||
000 Xxxxxxx 0, Xxxxx 00 | ||||||
Xxxxxxx, XX 00000-0000 | ||||||
Attn: Credit Manager |
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IN WITNESS WHEREOF, Compound Therapeutics, Inc. has caused this Warrant to be executed by its
officers thereunto duly authorized.
Dated as of September 25, 2003.
COMPOUND THERAPEUTICS, INC. | ||||||
By: | /s/ Xxxxx Xxx
|
|||||
Name: | Xxxxx Xxx | |||||
Title: | CEO | |||||
Accepted: | ||||
GENERAL ELECTRIC CAPITAL CORPORATION | ||||
By:
|
Xxxx Xxxx
|
|||
Title: SVP |
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NOTICE OF EXERCISE
TO:
The undersigned Warrantholder (“Holder”) elects to acquire shares of Stock (the “Common
Stock”) of , (the “Company”), pursuant to the terms of the Stock Purchase
Warrant dated , 2003 (the “Warrant”).
1. The Holder exercises its rights under the Warrant as set forth below:
( ) The Holder elects to
purchase shares of Common Stock as
provided in Section 3(a) and tenders herewith a check in the amount of $ as payment of the purchase price. |
( ) The Holder elects to convert the purchase rights into shares of Common Stock as provided in Section 3(b) of the Warrant. |
2. The Holder surrenders the Warrant with this Notice of Exercise.
The Holder represents that it is acquiring the aforesaid shares of Common Stock for investment and
not with a view to or for resale in connection with distribution and that the Holder has no present
intention of distributing or reselling the shares.
Please issue a certificate representing the shares of the Common Stock in the name of the Holder or
in such other name as is specified below:
Name: | ||||
Address: | ||||
Taxpayer I.D.: |
(Holder) | ||||||
By: | ||||||
Title: | ||||||
Date: | ||||||
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