ESCROW AGREEMENT
Exhibit 10.3
ESCROW AGREEMENT, dated as of May 5, 2011 (the “Agreement”) by and among (i) 00xx Xxxxxx
General Acquisition Corp., a Delaware corporation (“Parent”), (ii) Crumbs Holdings LLC, a Delaware
limited liability company (the “Company”), (iii) Xxxxx Xxxxx, Xxxxxx Xxxxx, Xxx Xxxxx, EHL Holdings
LLC, a Delaware limited liability company (“EHL”), and Xxxx Xxxxxxx (collectively the “Members”),
(iv) Xxxxx Xxxxx, in his capacity as Member Representative and Xxxxx Xxxxx, in his capacity as
Member Representative, and (v) Continental Stock Transfer & Trust Company, a New York corporation
(the “Escrow Agent”).
WHEREAS, Parent, 00xx Xxxxxx Merger Sub LLC, a Delaware limited liability company
(“Merger Sub”), the Company, the Members of the Company and the Member Representatives have entered
into that certain Business Combination Agreement, dated as of January 9, 2011, as amended or
modified on February 18, 2011, March 17, 2011, April 7, 2011, and May 5, 2011 (as may be further
amended or modified from time to time in accordance with its terms, the “BCA”), pursuant to which,
among other matters, Merger Sub shall be merged with and into the Company with the Company becoming
a non wholly-owned subsidiary of Parent (the “Merger”);
WHEREAS, it is a condition to the closing of the Merger under the BCA that the parties hereto
enter into this Agreement with terms and conditions reasonably satisfactory to the parties thereto;
WHEREAS, pursuant to the BCA, the parties to the BCA have agreed that certificates for Six
Hundred Fifty Thousand (650,000) New Crumbs Class B Exchangeable Units and Sixty-Five Thousand
(65,000) shares of Parent Series A Voting Preferred Stock (collectively, the “Claim Shares” and as
adjusted pursuant to this Agreement, the “Escrow Securities”) shall be placed into escrow as
hereinafter provided;
WHEREAS, the Claim Shares may potentially be forfeited and canceled as remedy of Parent and
Parent Indemnified Parties for the indemnification obligations of the Company and the Members as
set forth in the BCA, subject to the Members’ rights to substitute cash in lieu of forfeiture of
Claim Shares pursuant Section 1.6(b) of the BCA, but shall otherwise be released to the applicable
Members of the Company following expiration of the claim periods set forth in the BCA or as
otherwise provided by the BCA; and
WHEREAS, Parent, the Company, the Members and the Member Representatives desire that the
Escrow Agent accept the Escrow Securities, in escrow, to be held and disbursed as hereinafter
provided.
NOW, THERFORE, in consideration of the premises set forth above, which are incorporated in
this Agreement as if fully set forth below, and the representations, warranties, covenants and
agreements contained in this Agreement, and intending to be legally bound hereby, the parties
hereto agree as follows:
1. Capitalized Terms. All capitalized terms used but not otherwise defined in this
Agreement shall have the meanings ascribed to such terms in the BCA.
2. Appointment of Escrow Agent. Parent, the Company, the Members and the Member
Representatives hereby appoint the Escrow Agent to act in accordance with and subject to the terms
of this Agreement and the BCA and the Escrow Agent hereby accepts such appointment and agrees to
act in accordance with and subject to such terms.
3. Deposit of Escrow Securities. On or before the Closing Date, Parent and the
Company shall deliver to the Escrow Agent certificates representing their respective Escrow
Securities, in proper transfer order with guaranteed stock powers, to be held and disbursed subject
to the terms and conditions of this Agreement and the BCA. Parent, the Company and the Members
acknowledge and agree that the certificates representing the Escrow Securities will bear legends to
reflect the deposit of such Escrow Securities under this Agreement.
4. Disbursement of the Escrow Securities. The Escrow Agent shall cancel or disburse,
as the case may be, the Escrow Securities (i) within ten (10) days after receipt of written notice
executed by Parent, the Company and the Member Representatives (a “Letter of Direction”) or (ii)
pursuant to directions set forth in a final non-appealable judgment of a court having competent
jurisdiction over the matters contemplated hereby and only up to the amount set forth in such
Letter of Direction or judgment, as applicable. Each of Parent, the Company and the Member
Representatives agree to promptly deliver a Letter of Direction any time such Escrow Securities are
required to be cancelled or released under the terms of the BCA, including without limitation
pursuant to Sections 1.6(b) and 5.3 thereof, or this Agreement, including without limitation upon
the occurrence of the Claim Termination Date (as defined below). Unless released earlier pursuant
to this Section 4, the Escrow Agent shall hold each of the Escrow Securities until the expiration
of the Claim Shares Escrow Period (as defined below) applicable to such Escrow Securities. In the
case of the Claim Shares, the escrow period (the “Claims Share Escrow Period”) shall be the period
beginning on the date the certificates representing the Claim Shares are deposited with the Escrow
Agent and ending no later than one (1) month after the audited financial statements of Parent for
fiscal year 2011 shall have been completed (the “Claim Termination Date,” which unless tolled with
respect to specified Escrow Securities pursuant to the following proviso shall be deemed the date
upon which all Claims Share Escrow Periods expire), provided, however, that to the
extent a Claim Reservation Notice (as defined below) is timely delivered with respect to any Parent
Claims that remain unresolved at the time of the Claim Termination Date and notice of which was
properly and timely delivered pursuant to the BCA, the Claims Share Escrow Period shall be tolled
with respect to the Claim Shares specified in such Claim Reservation Notice, and the Escrow Agent
shall continue to hold the Claim Shares specified in such Claim Reservation Notice until the Parent
Claim applicable to any portion of such Claim Shares has been resolved pursuant to the BCA at which
time each of Parent, the Company and the Member Representatives shall promptly deliver a Letter of
Direction directing the Escrow Agent to cancel or release the applicable Claim Shares, as
appropriate, in accordance with such resolution. Parent, the Company and the Member
Representatives shall promptly deliver a written notice to the Escrow Agent (a “Claim Reservation
Notice”) to the extent any Parent Claims remain unresolved at the time of the Claim Termination
Date and notice of which was properly and timely delivered pursuant to the BCA specifying for each
such Parent Claim the number of such Claim Shares (which shall be a portion of the Claim Shares
reasonably necessary to satisfy such Parent Claims) that are to remain in
escrow until the
applicable Parent Claim is resolved. The Escrow Agent shall have no further duties hereunder after
the expiration of the Claim Shares Escrow Period applicable to all Escrow Securities and the
disbursement and/ or cancellation of the Escrow Securities in accordance with this Section 4.
5. Rights of Members in Escrow Securities.
5.1. Voting Rights
(a) Subject to the terms and conditions of the BCA, each Member of the Company (or its
Permitted Family Transferee to the extent applicable) shall (i) retain title to its allocable
portion of the Claim Shares, (ii) remain as the holder of record of the portion of the Claim Shares
registered on the books of Parent and Company, respectively, in the name of such Member (or its
Permitted Family Transferee to the extent applicable) or its respective nominees, and (iii) retain
all of its rights as a member of the Company and as a stockholder of Parent during the Claim Shares
Escrow Period including, without limitation, the right to vote the Claim Shares. Each of the
Escrow Agent (as directed by Parent and the Company in writing), the Company and Parent shall, upon
request, provide reasonable cooperation in facilitating such rights.
5.2. Dividends and Other Distributions in Respect of the Escrow Securities. Each of
the parties hereto agrees and acknowledges that during the Claim Shares Escrow Period, all
dividends or other distributions, whether payable in cash or otherwise, with respect to the Escrow
Securities shall be delivered by the Company and Parent, as applicable, directly to each Member to
whom such Escrow Securities are allocated (or their Permitted Family Transferees to the extent
applicable) and shall not constitute property subject to the terms of this Agreement.
5.3. Restrictions on Transfer. During the Claim Shares Escrow Period, no sale,
transfer or other disposition may be made of any or all of the Escrow Securities except as
permitted by the BCA; provided, however, that such transfers may be implemented only
pursuant to the terms and conditions of the BCA and upon the respective transferee’s written
agreement to be bound by the terms and conditions of this Agreement. Even if transferred in
accordance with this Section 5.3, the Escrow Securities will remain subject to this Agreement and
may be released from escrow only in accordance with Section 4 hereof. Each of Parent, the Company
and the Escrow Agent (as directed by Parent and the Company in writing) shall cooperate to replace
any relevant certificates representing applicable Escrow Securities to effect any such permitted
transfers. Furthermore, to the extent that Parent or the Company, as applicable, is required to
equitably adjust any Escrow Securities, each of Parent, the Company
and the Escrow Agent (as directed by Parent and the Company in writing) shall cooperate to
replace any relevant certificates representing applicable Escrow Securities to reflect any such
adjustments. In furtherance of the foregoing, the Company and Parent shall provide the Escrow
Agent with duly executed certificates for such purposes.
6. Concerning the Escrow Agent.
6.1. Good Faith Reliance. The Escrow Agent shall not be liable for any action taken
or omitted by it in good faith and in the exercise of its own best judgment, and may rely
conclusively and shall be protected in acting upon any order, notice, demand, certificate, opinion
or advice of counsel (including counsel chosen by the Escrow Agent), statement, instrument, report
or other paper or document (not only as to its due execution and the validity and effectiveness of
its provisions, but also as to the truth and acceptability of any information therein contained)
which is believed by the Escrow Agent in good faith to be genuine and to be signed or presented by
the proper party or parties. The Escrow Agent shall not be bound by any notice or demand, or any
waiver, modification, termination or rescission of this Agreement unless evidenced by a writing
delivered to the Escrow Agent signed by the proper party or parties and, if the duties or rights of
the Escrow Agent are affected, unless it shall have given its prior written consent thereto.
6.2. Indemnification. Except as set forth in Section 7.6, the Escrow Agent shall be
indemnified and held harmless by Parent, the Company, and the Members from and against any
expenses, including reasonable counsel fees and disbursements, or loss suffered by the Escrow Agent
in connection with any action taken by it hereunder, action, suit or other proceeding involving any
claim which in any way, directly or indirectly, arises out of or relates to this Agreement, the
services of the Escrow Agent hereunder, or the Escrow Securities held by it hereunder, other than
expenses or losses arising from the gross negligence or willful misconduct of the Escrow Agent.
Promptly after the receipt by the Escrow Agent of notice of any demand or claim or the commencement
of any action, suit or proceeding, the Escrow Agent shall notify the other parties hereto in
writing. In the event of the receipt of such notice, the Escrow Agent, in its sole discretion, may
commence an action in the nature of interpleader in an appropriate court of competent jurisdiction
to determine ownership or disposition of the Escrow Securities or it may deposit the Escrow
Securities with the clerk of any appropriate court of competent jurisdiction or it may retain the
Escrow Securities pending receipt of a final, non-appealable order of a court having competent
jurisdiction over all of the parties hereto directing to whom and under what circumstances the
Escrow Securities are to be canceled and/ or disbursed and delivered. The provisions of this
Section 6.2 shall survive in the event the Escrow Agent resigns or is discharged pursuant to
Sections 6.5 or 6.6 below.
6.3. Compensation. The Escrow Agent shall be entitled to reasonable compensation from
Parent and the Company for all services rendered by it hereunder, as set forth on Exhibit A
hereto. The Escrow Agent shall also be entitled to reimbursement from Parent and the Company for
all expenses paid or incurred by it in the administration of its duties hereunder including, but
not limited to, all counsel, advisors’ and agents’ fees and disbursements and all taxes or other
governmental charges.
6.4. Further Assurances. From time to time on and after the date hereof, each of
Parent, the Company, the Members and the Member Representatives shall deliver or cause to be
delivered to the Escrow Agent such further documents and instruments and shall do or cause to be
done such further acts as the Escrow Agent shall reasonably request to carry out more effectively
the provisions and purposes of this Agreement, to evidence compliance herewith or to assure itself
that it is protected in acting hereunder.
6.5. Resignation. The Escrow Agent may resign at any time and be discharged from its
duties as escrow agent hereunder by its giving the other parties hereto written notice and such
resignation shall become effective as hereinafter provided. Such resignation shall become effective
at such time that the Escrow Agent shall turn over to a successor escrow agent appointed by the
other parties hereto, which approval will not be unreasonably withheld, conditioned or delayed, the
Escrow Securities held hereunder. If no new escrow agent is so appointed within the 60 day period
following the giving of such notice of resignation, the Escrow Agent may deposit the Escrow
Securities with a court of competent jurisdiction that the Escrow Agent reasonably deems
appropriate.
6.6. Discharge of Escrow Agent. The Escrow Agent shall resign and be discharged from
its duties as escrow agent hereunder if so requested in writing at any time by the other parties
hereto, jointly, provided, however, that such resignation shall become effective only upon
acceptance of appointment by a successor escrow agent as provided in Section 6.5.
6.7. Liability. Notwithstanding anything herein to the contrary, the Escrow Agent
shall not be relieved from liability hereunder for its own gross negligence or its own willful
misconduct or bad faith.
7. Miscellaneous.
7.1. Governing Law. This Agreement shall for all purposes be deemed to be made under
and shall be construed in accordance with the laws of the State of Delaware without giving effect
to the principals of conflicts of law. Each of the parties hereby agrees that any action,
proceeding or claim against it arising out of or relating in any way to this Agreement shall be
brought and enforced in the courts of the State of Delaware or the United States District Court for
the District of Delaware, and irrevocably submits to such personal jurisdiction, which jurisdiction
shall be exclusive. Each of the parties hereby waives any objection to such exclusive jurisdiction
and that such courts represent an inconvenient forum.
7.2. Entire Agreement. This Agreement, the exhibits hereto and the BCA and the
agreements contemplated thereby contain the entire agreement of the parties hereto with respect to
the subject matter hereof and, except as expressly provided herein, may not be changed or modified
except by an instrument in writing signed by the party or parties to be bound thereby. In
connection with any proposed amendment, the Escrow Agent may request an opinion of Parent’s or the
Company’s counsel as to the validity of the proposed amendment as a condition to its execution of
said amendment and upon such request the party shall use commercially reasonable efforts to obtain
and deliver such legal opinion. Waivers of this Agreement or any of the terms and conditions
hereunder shall only be effective if in writing and
executed by the party or parties to be bound therewith. Any waiver of any term or condition
shall not be construed as a waiver of any subsequent breach or subsequent waiver of the same term
or condition, or a waiver of any other term or condition, of this Agreement.
7.3. Headings. The headings contained in this Agreement are for reference purposes
only and shall not affect in any way the meaning or interpretation thereof.
7.4. Binding Effect; Assignment. This Agreement shall be binding upon and inure to
the benefit of the respective parties hereto and their legal representative, successors and
permitted assigns. Neither this Agreement nor any right or interest hereunder may be assigned in
whole or in part by any party without the prior consent of the other
parties hereto; provided,
however, that a Member may assign its rights hereunder in whole or part in connection with a
transfer of its allocable portion of the Escrow Securities in accordance with the BCA.
7.5. Notices. Any notice or other communication required or which may be given
hereunder shall be in writing and either be delivered personally or by private national courier
service, or be mailed, certified or registered mail, return receipt requested, postage prepaid, and
shall be deemed given when so delivered personally or, if sent by private national courier service,
on the next business day after delivery to the courier, or, if mailed, two business days after the
date of mailing, as follows:
if to the Escrow Agent, to:
Continental Stock Transfer & Trust Company
00 Xxxxxxx Xxxxx
Xxx Xxxx, XX 00000
Attention: Xxxxx XxXxxx
00 Xxxxxxx Xxxxx
Xxx Xxxx, XX 00000
Attention: Xxxxx XxXxxx
if to Parent, to:
00xx Xxxxxx General Acquisition Corp.
c/o Crumbs Holdings LLC
000 Xxxx 00xx Xxxxxx, Xxxxx 0000
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxx
c/o Crumbs Holdings LLC
000 Xxxx 00xx Xxxxxx, Xxxxx 0000
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxx
and a copy, which shall not constitute notice, to:
Ellenoff, Xxxxxxxx & Schole LLP
000 Xxxx 00xx Xxxxxx, 00xx Xxxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxxxx Xxxxxxxx, Esq.
000 Xxxx 00xx Xxxxxx, 00xx Xxxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxxxx Xxxxxxxx, Esq.
if to the Company, to:
Crumbs Holdings LLC
000 Xxxx 00xx Xxxxxx, Xxxxx 0000
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxx
000 Xxxx 00xx Xxxxxx, Xxxxx 0000
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxx
and a copy, which shall not constitute notice, to:
Akin Gump Xxxxxxx Xxxxx & Xxxx LLP
Xxx Xxxxxx Xxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxxxxxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxxxxxxx
if to a Member (as the case may be), to:
the notice address set forth on Exhibit B hereto
and a copy, which shall not constitute notice, to:
Akin Gump Xxxxxxx Xxxxx & Xxxx LLP
Xxx Xxxxxx Xxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxxxxxxx
Facsimile: (000) 000-0000
Xxx Xxxxxx Xxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxxxxxxx
Facsimile: (000) 000-0000
if to a Member Representative (as the case may be), to:
Xxxxx Xxxxx
Crumbs Holdings LLC
000 Xxxx 00xx Xxxxxx, Xxxxx 0000
Xxx Xxxx, Xxx Xxxx 00000
Crumbs Holdings LLC
000 Xxxx 00xx Xxxxxx, Xxxxx 0000
Xxx Xxxx, Xxx Xxxx 00000
Xxxxx Xxxxx
000 X. Xxxxxx Xx. Xxx 0
Xxxxxx, XX 00000
000 X. Xxxxxx Xx. Xxx 0
Xxxxxx, XX 00000
and a copy, which shall not constitute notice, to:
Akin Gump Xxxxxxx Xxxxx & Xxxx LLP
Xxx Xxxxxx Xxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxxxxxxx
Facsimile: (000) 000-0000
Xxx Xxxxxx Xxxx
Xxx Xxxx, Xxx Xxxx 00000
Attention: Xxxxx Xxxxxxxxxx
Facsimile: (000) 000-0000
The parties may change the persons and addresses to which the notices or other communications
are to be sent by giving written notice to any such change in the manner provided herein for giving
notice.
7.6. Trust Account Waiver. For and in consideration of the Escrow Agent entering into
this Agreement and for other good and valuable consideration, the receipt and sufficiency of which
is hereby acknowledged, the Escrow Agent hereby agrees it does not now and shall not at any time
hereafter have any right, title, interest or claim of any kind in or to any monies in the Trust
Fund, or Distributions therefrom, or make any claim against the Trust Fund and/ or Distributions,
regardless of whether such claim arises as a result of, in connection with or relating in any way
to, any proposed or actual business relationship between Parent and the
Escrow Agent, this
Agreement or any other matter, and regardless of whether such claim arises based on contract, tort,
equity or any other theory of legal liability. The Escrow hereby irrevocably waives any claims it
may have against the Trust Fund and/ or Distributions now or in the future as a result of, or
arising out of, any negotiations, contracts or agreements with Parent and will not seek recourse
against the Trust Fund for any reason whatsoever (including, without limitation, for an alleged
breach of this Agreement). To the extent the Escrow Agent commences any action or proceeding based
upon, in connection with, relating to or arising out of any matter relating to Parent, which
proceeding seeks, in whole or in part, monetary relief against Parent, the Escrow Agent hereby
acknowledges and agrees its sole remedy shall be against funds held outside of the Trust Fund and
Distributions and that such claim shall not permit the Escrow Agent (or any person or entity
claiming on behalf of the Escrow Agent) to have any claim against the Trust Fund, Distributions
and/ or any amounts contained therein. In the event that the Escrow Agent commences any action or
proceeding based upon, in connection with, relating to or arising out of any matter relating to
Parent, which proceeding seeks, in whole or in part, relief against the Trust Fund or the Public
Stockholders, whether in the form of money damages or injunctive relief, Parent shall be entitled
to recover from the Escrow Agent, as the case may be, the associated legal fees and costs in
connection with any such action, in the event Parent prevails in such action or proceeding.
7.7. Counterparts. This Agreement may be executed in several counterparts each
one of which shall constitute an original and may be delivered by facsimile transmission and
together shall constitute one instrument.
7.8 Termination. This Agreement shall terminate on the date on which there are no
Escrow Securities held by the Escrow Agent, subject to the survival of provisions which expressly
survive the termination of this Agreement.
7.9 No Third Party Beneficiaries. Except as otherwise expressly provided herein,
nothing contained in this Agreement or any instrument or document executed by any party in
connection with the transactions contemplated hereby shall create any rights in, or be deemed to
have been executed for the benefit of, any person that is not a party hereto or thereto or a
permitted assign of such a party.
[remainder of page intentionally left blank]
IN WITNESS WHEREOF, the parties hereto have caused the execution of this Agreement as of
the date first above written.
57TH STREET GENERAL ACQUISITION CORP. |
||||
By: | /s/ Xxxx Xxxxxxx | |||
Name: | Xxxx Xxxxxxx | |||
Title: | CFO, Secretary and Treasurer | |||
CRUMBS HOLDINGS LLC |
||||
By: | /s/Xxxxx Xxxxx | |||
Name: | Xxxxx Xxxxx | |||
Title: | Chief Executive Officer | |||
/s/ Xxxxx Xxxxx | ||||
Xxxxx Xxxxx | ||||
/s/ Xxxxx Xxxxx | ||||
Xxxxx Xxxxx | ||||
CONTINENTAL STOCK TRANSFER & TRUST COMPANY |
||||
By: | /s/ Xxxx X. Xxxxxx, Xx. | |||
Name: | Xxxx X. Xxxxx, Xx. | |||
Title: | Vice President | |||
MEMBERS: |
|||||
/s/ Xxxxx Xxxxx | |||||
Xxxxx Xxxxx | |||||
/s/ Xxx Xxxxx | |||||
Xxx Xxxxx | |||||
/s/ Xxxxxx Xxxxx | |||||
Xxxxxx Xxxxx | |||||
CRUMBS, INC. |
|||||
By: | /s/ Xxxxx Xxxxx | ||||
Name: | Xxxxx Xxxxx | ||||
Title: | President | ||||
EHL HOLDINGS LLC |
|||||
By: | /s/ Xxxxx Xxxxx | ||||
Name: | Xxxxx Xxxxx | ||||
Title: | Chairman | ||||
/s/ Xxxx X. Ireland | |||||
Xxxx X. Ireland | |||||
EXHIBIT A
Escrow Agent Fees
$2,500 for the first year and $200 for each month after the first year for acting as escrow agent.
First year agent fee to be paid at closing.
EXHIBIT B
Member Notices
Name | Address | |
Xxxxx Xxxxx
|
Crumbs Holdings LLC 000 Xxxx 00xx Xxxxxx Xxxxx 0000 Xxx Xxxx, Xxx Xxxx 00000 Attention: Xxxxx Xxxxx Facsimile: (000) 000-0000 |
|
Xxx Xxxxx
|
c/o Xxxxx Xxxxx Crumbs Holdings LLC 000 Xxxx 00xx Xxxxxx Xxxxx 0000 Xxx Xxxx, Xxx Xxxx 00000 Attention: Xxxxx Xxxxx Facsimile: (000) 000-0000 |
|
Xxxxxx Xxxxx
|
000 Xxxx 00xx Xxxxxx Xxx 00X Xxx Xxxx, XX 00000 Facsimile: (000) 000-0000 |
|
Crumbs, Inc.
|
c/o Crumbs Holdings LLC 000 Xxxx 00xx Xxxxxx Xxxxx 0000 Xxx Xxxx, Xxx Xxxx 00000 Attention: Xxxxx Xxxxx Facsimile: (000) 000-0000 |
|
000 X. Xxxxxx Xx. Xxx 0 Xxxxxx, XX 00000 Facsimile: (000) 000-0000 Attention: Xxxxx Xxxxx |
||
Xxxx X. Ireland
|
c/o Crumbs Holdings LLC 00000 Xxxxxxxxx Xx Xxxxxx, XX 00000 Facsimile: (000) 000-0000 |