IRREVOCABLE TRANSFER AGENT INSTRUCTIONS
October 6, 2005
Worldwide Stock Transfer, LLC
000 Xxxxx Xxxx Xxxx
Xxxxxxx, XX 00000
RE: SENSOR SYSTEM SOLUTIONS, INC.
Ladies and Gentlemen:
Reference is made to that certain Securities Purchase Agreement (the
"Securities Purchase Agreement") of even date herewith by and between Sensor
System Solutions, Inc., a Nevada corporation (the "Company"), and the Buyers set
forth on Schedule I attached thereto (collectively the "Buyers") and that
certain Pledge and Escrow Agreement (the "Pledge Agreement") of even date
herewith among the Company, the Buyers, Xxxxxxx Xxxxx and Xxxxx Xxxxxxxx, as
escrow agent (the "Escrow Agent"). Pursuant to the Securities Purchase
Agreement, the Company shall sell to the Buyers, and the Buyers shall purchase
from the Company, convertible debentures (collectively, the "Debentures") in the
aggregate principal amount of Six Hundred Thousand Dollars ($600,000), plus
accrued interest, which are convertible into shares of the Company's common
stock, par value $.01 per share (the "Common Stock"), at the Buyers discretion.
The Company has also issued to the Buyers warrants to purchase up to 600,000
shares of Common Stock, at the Buyer discretion (the "Warrant"). These
instructions relate to the following stock or proposed stock issuances or
transfers:
1. The Company has agreed to issue to the Buyers up to 2,448,980
shares of the Company's Common Stock upon conversion of the
Debentures ("Conversion Shares") plus the shares of Common
Stock to be issued to the Buyers upon conversion of accrued
interest and liquidated damages into Common Stock (the
"Interest Shares").
2. Xxxxxxx Xxxxx has prepared a stock certificate representing
10,075,357 shares (the "Escrowed Shares") of Common Stock,
which have been delivered to the Escrow Agent pursuant to the
Pledge Agreement.
3. Up to 600,000 shares of Common Stock to be issued upon the
exercise of the Warrant ("Warrant Shares").
This letter shall serve as our irrevocable authorization and direction to
Worldwide Stock Transfer, LLC (the "Transfer Agent") to do the following:
1. Conversion Shares.
a. Instructions Applicable to Transfer Agent. With respect to the
Conversion Shares and the Interest Shares, the Transfer Agent
shall issue the Conversion Shares and the Interest Shares to
the Buyers from time to time upon delivery to the Transfer
Agent of a properly completed and duly executed Conversion
Notice (the "Conversion Notice"), in the form attached hereto
as Exhibit I, delivered on behalf of the Company to the
Transfer Agent by the Escrow Agent. Upon receipt of a
Conversion Notice, the Transfer Agent shall within three (3)
Trading Days thereafter (i) issue and surrender to a common
carrier for overnight delivery to the address as specified in
the Conversion Notice, a certificate, registered in the name
of the Buyers or their designees, for the number of shares of
Common Stock to which the Buyers shall be entitled as set
forth in the Conversion Notice or (ii) provided Transfer Agent
are participating in The Depository Trust Company ("DTC") Fast
Automated Securities Transfer Program, upon the request of the
Buyers, credit such aggregate number of shares of Common Stock
to which the Buyers shall be entitled to the Buyers' or their
designees' balance account with DTC through its Deposit
Withdrawal At Custodian ("DWAC") system provided the Buyers
causes its bank or broker to initiate the DWAC transaction.
For purposes hereof "Trading Day" shall mean any day on which
the Nasdaq Market is open for customary trading.
b. The Company hereby confirms to the Transfer Agent and the
Buyers that certificates representing the Conversion Shares
shall not bear any legend restricting transfer and should not
be subject to any stop-transfer restrictions and shall
otherwise be freely transferable on the books and records of
the Company; provided that counsel to the Company delivers (i)
the Notice of Effectiveness set forth in Exhibit II attached
hereto and (ii) an opinion of counsel in the form set forth in
Exhibit III attached hereto, and that if the Conversion Shares
and the Interest Shares are not registered for sale under the
Securities Act of 1933, as amended, then the certificates for
the Conversion Shares and Interest Shares shall bear the
following legend:
"THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN
REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR
APPLICABLE STATE SECURITIES LAWS. THE SECURITIES HAVE BEEN
ACQUIRED FOR INVESTMENT AND MAY NOT BE OFFERED FOR SALE, SOLD,
TRANSFERRED OR ASSIGNED IN THE ABSENCE OF AN EFFECTIVE
REGISTRATION STATEMENT FOR THE SECURITIES UNDER THE SECURITIES
ACT OF 1933, AS AMENDED, OR APPLICABLE STATE SECURITIES LAWS,
OR AN OPINION OF COUNSEL, IN A FORM REASONABLY ACCEPTABLE TO
THE COMPANY, THAT REGISTRATION IS NOT REQUIRED UNDER SAID ACT
OR APPLICABLE STATE SECURITIES LAWS OR UNLESS SOLD PURSUANT TO
RULE 144 UNDER SAID ACT."
2
c. In the event that counsel to the Company fails or refuses to
render an opinion as required to issue the Conversion Shares
in accordance with the preceding paragraph (either with or
without restrictive legends, as applicable), then the Company
irrevocably and expressly authorizes counsel to the Buyers to
render such opinion. The Transfer Agent shall accept and be
entitled to rely on such opinion for the purposes of issuing
the Conversion Shares.
d. Instructions Applicable to Escrow Agent. Upon the Escrow
Agent's receipt of a properly completed conversion notice
substantially in the form attached as an exhibit to the
Debentures, the Escrow Agent shall, within one (1) Trading Day
thereafter, send to the Transfer Agent a Conversion Notice in
the form attached hereto as Exhibit I, which shall constitute
an irrevocable instruction to the Transfer Agent to process
such Conversion Notice in accordance with the terms of these
instructions.
2. Escrowed Shares.
a. With respect to the Escrowed Shares, upon an event of default
as set forth in the Pledge Agreement, the Escrow Agent shall
send written notice to the Transfer Agent ("Escrow Notice") to
transfer such number of Escrow Shares as set forth in the
Escrow Notice to the Buyers. Upon receipt of an Escrow Notice,
the Transfer Agent shall promptly transfer such number of
Escrow Shares to the Buyers as shall be set forth in the
Escrow Notice delivered to the Transfer Agent by the Escrow
Agent. Further, the Transfer Agent shall promptly transfer
such shares from the Buyers to any subsequent transferee
promptly upon receipt of written notice from the Buyers or
their counsel. If the Escrow Shares are not registered for
sale under the Securities Act of 1933, as amended, then the
certificates for the Escrow Shares shall bear the legend set
forth in Section 1b.
b. In the event that counsel to the Company fails or refuses to
render an opinion as may be required by the Transfer Agent to
affect a transfer of the Escrow Shares (either with or without
restrictive legends, as applicable), then the Company
irrevocably and expressly authorizes counsel to the Buyers to
render such opinion. The Transfer Agent shall accept and be
entitles to rely on such opinion for the purpose of
transferring the Escrow Shares.
3. Warrant Shares.
a. Instructions Applicable to Transfer Agent. With respect to the
Warrant Shares, the Transfer Agent shall issue the Warrant
Shares to the Buyer from time to time upon delivery to the
Transfer Agent of a properly completed and duly executed
notice of the Buyer's election to exercise the Warrant (the
"Exercise Notice"), in the form attached hereto as Exhibit IV,
specifying the number of Warrant Shares to be issued,
delivered on behalf of the Company to
3
the Transfer Agent by the Xxxxx Xxxxxxxx, Esq., as escrow
agent (the "Escrow Agent"). Upon receipt of an Exercise
Notice, the Transfer Agent shall use its best efforts to
within three (3) Trading Days thereafter (i) issue and
surrender to a common carrier for overnight delivery to the
address as specified in the Exercise Notice, a certificate,
registered in the name of the Buyer or its designees, for the
number of shares of Common Stock to which the Buyer shall be
entitled as set forth in the Exercise Notice or (ii) provided
Transfer Agent are participating in The Depository Trust
Company ("DTC") Fast Automated Securities Transfer Program,
upon the request of the Buyer, credit such aggregate number of
shares of Common Stock to which the Buyer shall be entitled to
the Buyer's or its designees' balance account with DTC through
its Deposit Withdrawal At Custodian ("DWAC") system provided
the Buyer causes its bank or broker to initiate the DWAC
transaction. For purposes hereof "Trading Day" shall mean any
day on which the Nasdaq Market is open for customary trading.
The Company hereby confirms to the Transfer Agent and Cornell
that certificates representing the Warrant Shares shall not
bear any legend restricting transfer and should not be subject
to any stop-transfer restrictions and shall otherwise be
freely transferable on the books and records of the Company;
provided that counsel to the Company delivers (i) the Notice
of Effectiveness set forth in Exhibit II attached hereto and
(ii) an opinion of counsel in the form set forth in Exhibit
III attached hereto, and that if the Warrant Shares are not
registered for sale under the Securities Act of 1933, as
amended, then the certificates for the Warrant Shares shall
bear the restrictive legend referenced above in Section 1b.
b. In the event that counsel to the Company fails or refuses to
render an opinion as required to issue the Warrant Shares in
accordance with the preceding paragraph (either with or
without restrictive legends, as applicable), then the Company
irrevocably and expressly authorizes counsel to the Buyer to
render such opinion. The Transfer Agent shall accept and be
entitled to rely on such opinion for the purposes of issuing
the Warrant Shares.
c. Instructions Applicable to Escrow Agent. Upon the Escrow
Agent's receipt of a properly completed exercise notice
substantially in the form attached as an exhibit to the
Warrant and the Aggregate Exercise Price (as defined in the
Warrant), the Escrow Agent shall, within one (1) Trading Day
thereafter, send to the Transfer Agent an Exercise Notice in
the form attached hereto as Exhibit I, which shall constitute
an irrevocable instruction to the Transfer Agent to process
such Exercise Notice in accordance with the terms of these
instructions.
4
4. All Shares.
a. The Transfer Agent shall reserve for issuance to the
Buyers the Conversion Shares, the Escrowed Shares, and the
Warrant Shares. All such shares shall remain in reserve
with the Transfer Agent until the Buyers provides the
Transfer Agent instructions that the shares or any part of
them shall be taken out of reserve and shall no longer be
subject to the terms of these instructions.
b. The Transfer Agent shall rely exclusively on the
Conversion Notice, the Escrow Notice, or the Exercise
Notice and shall have no liability for relying on such
instructions. Any Conversion Notice, Escrow Notice, or
Exercise Notice delivered hereunder shall constitute an
irrevocable instruction to the Transfer Agent to process
such notice or notices in accordance with the terms
thereof. Such notice or notices may be transmitted to the
Transfer Agent by facsimile or any commercially reasonable
method.
c. The Company hereby confirms to the Transfer Agent and the
Buyers that no instructions other than as contemplated
herein will be given to Transfer Agent by the Company with
respect to the matters referenced herein. The Company
hereby authorizes the Transfer Agent, and the Transfer
Agent shall be obligated, to disregard any contrary
instructions received by or on behalf of the Company.
Certain Notice Regarding the Escrow Agent. The Company and the Transfer
Agent hereby acknowledge that the Escrow Agent is general counsel to the Buyers,
a partner of the general partner of the Buyers and counsel to the Buyers in
connection with the transactions contemplated and referred herein. The Company
and the Transfer Agent agree that in the event of any dispute arising in
connection with this Agreement or otherwise in connection with any transaction
or agreement contemplated and referred herein, the Escrow Agent shall be
permitted to continue to represent the Buyers and neither the Company nor the
Transfer Agent will seek to disqualify such counsel.
The Company hereby agrees that it shall not replace the Transfer Agent as
the Company's transfer agent without the prior written consent of the Buyers.
Any attempt by Transfer Agent to resign as the Company's transfer agent
hereunder shall not be effective until such time as the Company provides to the
Transfer Agent written notice that a suitable replacement has agreed to serve as
transfer agent and to be bound by the terms and conditions of these Irrevocable
Transfer Agent Instructions.
The Company herby confirms and the Transfer Agent acknowledges that while
any portion of the Debentures remains unpaid and unconverted with the exception
Common Stock issuable to Cornell Capital Partners, LP pursuant to the Standby
Equity Distribution Agreement, the Company and the Transfer Agent shall not,
without the prior consent of the Buyers, (i) issue any Common Stock or Preferred
Stock without consideration or for a consideration per share less than its fair
market value determined immediately prior to its issuance, (ii) issue any
Preferred Stock, warrant, option, right, contract, call, or other security or
instrument granting the
5
holder thereof the right to acquire Common Stock without consideration or for a
consideration per share less than such Common Stock's fair market value
determined immediately prior to its issuance, (iii) issue any S-8 shares of the
Company's Common Stock. The restrictions set forth in subparagraphs (i) and (ii)
above shall not apply to (i) the issuance of shares of Common Stock to the
individuals listed on Schedule 4(k)(1) attached to the Securities Purchase
Agreement (the "Securities Purchase Agreement") of even date herewith between
the Obligor and Cornell Capital Partners, LP, in the individual's name (the
"Loan Conversions"); (ii) grants of options to employees of the Obligor and the
issuance of shares of Common Stock underlying such options, pursuant to a stock
option plan for employees to be adopted by the Obligor at a future date (the
"Stock Option Plan"), provided, however, that any and all grants under the Stock
Option Plan, in the aggregate, shall not exceed five million (5,000,000) shares
of Common Stock, shall be granted in accordance with Schedule 4(k)(2) of the
Securities Purchase Agreement, and shall vest pro rata not less than over a
three (3) year period from the respective dates of grant; and (iii) warrants to
purchase up to One Million (1,000,000) shares of Common Stock to be issued to
Trendwith Securities, Inc. and its designees in connection with the transactions
contemplated in the Securities Purchase Agreement (the "Trendwith Warrants"),
provided, however, that the exercise price of the Trendwith Warrants shall not
be less than the Bid Price of the Common Stock on the date of issuance of such
warrants.
The Company, the Transfer Agent and the Buyers hereby acknowledge that the
Transfer Agent has recently been engaged by the Company to perform services as a
transfer agent and that the Transfer Agent has not received the Company's
records from Stalt, Inc., the Company's prior transfer agent. The Company, the
Transfer Agent and the Buyers hereby agree that the Transfer Agent's obligations
hereunder are contingent upon the Transfer Agent receiving all reasonably
requested documents from either Stalt, Inc. and/or the Company.
The Company and the Transfer Agent hereby acknowledge and confirm that
complying with the terms of this Agreement does not and shall not prohibit the
Transfer Agent from satisfying any and all fiduciary responsibilities and duties
it may owe to the Company.
The Company and the Transfer Agent acknowledge that the Buyers is relying
on the representations and covenants made by the Company and the Transfer Agent
hereunder and are a material inducement to the Buyers purchasing convertible
debentures under the Securities Purchase Agreement. The Company and the Transfer
Agent further acknowledge that without such representations and covenants of the
Company and the Transfer Agent made hereunder, the Buyers would not purchase the
Debentures.
Each party hereto specifically acknowledges and agrees that in the event
of a breach or threatened breach by a party hereto of any provision hereof, the
Buyers will be irreparably damaged and that damages at law would be an
inadequate remedy if these Irrevocable Transfer Agent Instructions were not
specifically enforced. Therefore, in the event of a breach or threatened breach
by a party hereto, including, without limitation, the attempted termination of
the agency relationship created by this instrument, the Buyers shall be
entitled, in addition to all other rights or remedies, to an injunction
restraining such breach, without being required to show any actual damage or to
post any bond or other security, and/or to a decree for specific performance of
the provisions of these Irrevocable Transfer Agent Instructions.
6
IN WITNESS WHEREOF, the parties have caused this letter agreement
regarding Irrevocable Transfer Agent Instructions to be duly executed and
delivered as of the date first written above.
COMPANY:
SENSOR SYSTEM SOLUTIONS, INC.
By: /s/ Xxxxxxx Xxxxx
----------------------------
Name: Xxxxxxx Xxxxx
Title: Chief Executive Officer
/s/ Xxxxx Xxxxxxxx
-------------------------------------
Xxxxx Xxxxxxxx, Esq.
WORLDWIDE STOCK TRANSFER, LLC
By: /s/ Xxxxx Xxxxxxxx
---------------------------------------
Name: Xxxxx Xxxxxxxx
-------------------------------------
Title: Authorized Person
------------------------------------
7
SCHEDULE I
SCHEDULE OF BUYERS
Address/Facsimile
Name Signature Number of Buyers
------------------------------ -------------------------------- ----------------------------------
Cornell Capital Partners, LP By: Yorkville Advisors, LLC 000 Xxxxxx Xxxxxx - Xxxxx 0000
Xxx: Xxxxxxx Xxxxxxx Xxxxxx Xxxx, XX 00000
Facsimile: (000) 000-0000
By: /s/ Xxxx Xxxxxx
-----------------------
Name: Xxxx Xxxxxx
Its: Portfolio Manager
SCHEDULE I-1
EXHIBIT I
TO IRREVOCABLE TRANSFER AGENT INSTRUCTIONS
FORM OF CONVERSION NOTICE
Reference is made to the Securities Purchase Agreement (the "Securities
Purchase Agreement") between Sensor System Solutions, Inc., (the "Company"), and
the Buyers set forth on Schedule I attached thereto dated October 6, 2005. In
accordance with and pursuant to the Securities Purchase Agreement, the
undersigned hereby elects to convert convertible debentures into shares of
common stock, par value $.01 per share (the "Common Stock"), of the Company for
the amount indicated below as of the date specified below.
Conversion Date:
Amount to be converted: $____________________
Conversion Price: $____________________
Shares of Common Stock Issuable: ____________________
Amount of Debenture unconverted: $____________________
Amount of Interest Converted: $____________________
Conversion Price of Interest: $____________________
Shares of Common Stock Issuable: ____________________
Amount of Liquidated Damages: $____________________
Conversion Price of Liquidated Damages: $____________________
Shares of Common Stock Issuable: ____________________
Total Number of shares of Common Stock to be issued: ____________________
EXHIBIT I-1
Please issue the shares of Common Stock in the following name and to the
following address:
Issue to: ______________________________
Authorized Signature: ______________________________
Name: ______________________________
Title: ______________________________
Phone #: ______________________________
Broker DTC Participant Code: ______________________________
Account Number*: ______________________________
* Note that receiving broker must initiate transaction on DWAC System.
2
EXHIBIT II
TO IRREVOCABLE TRANSFER AGENT INSTRUCTIONS
FORM OF NOTICE OF EFFECTIVENESS
OF REGISTRATION STATEMENT
_________, 2005
_________
Attention:
RE: SENSOR SYSTEM SOLUTIONS, INC.
Ladies and Gentlemen:
We are counsel to Sensor System Solutions, Inc., (the "Company"), and
have represented the Company in connection with that certain Securities Purchase
Agreement, dated as of October 6, 2005 (the "Securities Purchase Agreement"),
entered into by and among the Company and the Buyers set forth on Schedule I
attached thereto (collectively the "Buyers") pursuant to which the Company has
agreed to sell to the Buyers up to Six Hundred Thousand Dollars ($600,000) of
secured convertible debentures, which shall be convertible into shares (the
"Conversion Shares") of the Company's common stock, par value $.01 per share
(the "Common Stock"), in accordance with the terms of the Securities Purchase
Agreement. Pursuant to the Securities Purchase Agreement, the Company also has
entered into a Registration Rights Agreement, dated as of October 6, 2005, with
the Buyers (the "Investor Registration Rights Agreement") pursuant to which the
Company agreed, among other things, to register the Conversion Shares under the
Securities Act of 1933, as amended (the "1933 Act"). In connection with the
Company's obligations under the Securities Purchase Agreement and the
Registration Rights Agreement, on _______, 2005, the Company filed a
Registration Statement (File No. ___-_________) (the "Registration Statement")
with the Securities and Exchange Commission (the "SEC") relating to the sale of
the Conversion Shares.
In connection with the foregoing, we advise the Transfer Agent that a
member of the SEC's staff has advised us by telephone that the SEC has entered
an order declaring the Registration Statement effective under the 1933 Act at
____ P.M. on __________, 2005 and we have no knowledge, after telephonic inquiry
of a member of the SEC's staff, that any stop order suspending its effectiveness
has been issued or that any proceedings for that purpose are pending before, or
threatened by, the SEC and the Conversion Shares are available for sale under
the 1933 Act pursuant to the Registration Statement.
EXHIBIT II-1
The Buyers has confirmed it shall comply with all securities laws and
regulations applicable to it including applicable prospectus delivery
requirements upon sale of the Conversion Shares.
Very truly yours,
By:________________________
EXHIBIT II-2
EXHIBIT III
TO IRREVOCABLE TRANSFER AGENT INSTRUCTIONS
FORM OF OPINION
________________ 2005
VIA FACSIMILE AND REGULAR MAIL
Worldwide Stock Transfer, LLC
000 Xxxxx Xxxx Xxxx
Xxxxxxx, XX 00000
Attention:
RE: SENSOR SYSTEM SOLUTIONS, INC.
Ladies and Gentlemen:
We have acted as special counsel to Sensor System Solutions, Inc. (the
"Company"), in connection with the registration of ___________shares (the
"Shares") of its common stock with the Securities and Exchange Commission (the
"SEC"). We have not acted as your counsel. This opinion is given at the request
and with the consent of the Company.
In rendering this opinion we have relied on the accuracy of the
Company's Registration Statement on Form SB-2, as amended (the "Registration
Statement"), filed by the Company with the SEC on _________ ___, 2005. The
Company filed the Registration Statement on behalf of certain selling
stockholders (the "Selling Stockholders"). This opinion relates solely to the
Selling Shareholders listed on Exhibit "A" hereto and number of Shares set forth
opposite such Selling Stockholders' names. The SEC declared the Registration
Statement effective on __________ ___, 2005.
We understand that the Selling Stockholders acquired the Shares in a
private offering exempt from registration under the Securities Act of 1933, as
amended. Information regarding the Shares to be sold by the Selling Shareholders
is contained under the heading "Selling Stockholders" in the Registration
Statement, which information is incorporated herein by reference. This opinion
does not relate to the issuance of the Shares to the Selling Stockholders. The
opinions set forth herein relate solely to the sale or transfer by the Selling
Stockholders pursuant to the Registration Statement under the Federal laws of
the United States of America. We do not express any opinion concerning any law
of any state or other jurisdiction.
EXHIBIT IV
In rendering this opinion we have relied upon the accuracy of the
foregoing statements.
Based on the foregoing, it is our opinion that the Shares have been
registered with the Securities and Exchange Commission under the Securities Act
of 1933, as amended, and that Worldwide Stock Transfer, LLC may remove the
restrictive legends contained on the Shares. This opinion relates solely to the
number of Shares set forth opposite the Selling Stockholders listed on Exhibit
"A" hereto.
This opinion is furnished to Transfer Agent specifically in connection
with the issuance of the Shares, and solely for your information and benefit.
This letter may not be relied upon by Transfer Agent in any other connection,
and it may not be relied upon by any other person or entity for any purpose
without our prior written consent. This opinion may not be assigned, quoted or
used without our prior written consent. The opinions set forth herein are
rendered as of the date hereof and we will not supplement this opinion with
respect to changes in the law or factual matters subsequent to the date hereof.
Very truly yours,
EXHIBIT III-2
EXHIBIT IV
TO IRREVOCABLE TRANSFER AGENT INSTRUCTIONS
FORM OF WARRANT EXERCISE NOTICE
TO BE EXECUTED
BY THE REGISTERED HOLDER TO EXERCISE THIS WARRANT
SENSOR SYSTEM SOLUTIONS, INC.
The undersigned holder hereby exercises the right to purchase
______________ of the shares of Common Stock par value $0.01 per share ("Warrant
Shares") of Sensor System Solutions, Inc., a Nevada corporation (the "Company"),
evidenced by the attached Warrant (the "Warrant"). Capitalized terms used herein
and not otherwise defined shall have the respective meanings set forth in the
Warrant.
Specify Method of exercise by check mark:
1. ___ Cash Exercise
(a) Payment of Warrant Exercise Price. The holder shall pay the
Aggregate Exercise Price of $______________ to the Company in
accordance with the terms of the Warrant.
(b) Delivery of Warrant Shares. The Company shall deliver to the
holder _________ Warrant Shares in accordance with the terms of
the Warrant.
2. ___ Cashless Exercise
(a) Payment of Warrant Exercise Price. In lieu of making payment
of the Aggregate Exercise Price, the holder elects to receive
upon such exercise the Net Number of shares of Common Stock
determined in accordance with the terms of the Warrant.
(b) Delivery of Warrant Shares. The Company shall deliver to the
holder _________ Warrant Shares in accordance with the terms of
the Warrant.
Date: _______________ __, ______
Name of Registered Holder
By:
-----------------------------
Name:
---------------------------
Title:
--------------------------
EXHIBIT IV
EXHIBIT "A"
(LIST OF SELLING STOCKHOLDERS)
Name: No. of Shares:
--------------------------------------------------------- --------------
EXHIBIT A
