Daytime Telephone Number definition

Daytime Telephone Number. Taxpayer ID #:___________________________

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Daytime Telephone Number. Daytime FAX Number: ________________________ GENESYS TELECOMMUNICATIONS LABORATORIES, INC. ______________________ INVESTOR QUESTIONNAIRE ______________________ INSTRUCTIONS: PLEASE COMPLETE THIS INVESTOR QUESTIONNAIRE BY FILLING IN THE INFORMATION CALLED FOR, CHECKING THE APPROPRIATE BOXES AND SIGNING AT PAGE 2. PLEASE RETURN THE COMPLETED QUESTIONNAIRE TO ▇▇▇▇▇ ▇. ▇▇▇▇▇, ESQ., ▇▇▇▇ ▇▇▇▇ ▇▇▇▇ & FRIEDENRICH, ▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇▇, ▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇-▇▇▇▇. GENESYS TELECOMMUNICATIONS LABORATORIES, INC. ______________________ INVESTOR QUESTIONNAIRE ______________________ TO: GENESYS TELECOMMUNICATIONS LABORATORIES, INC. Ladies and Gentlemen: The undersigned hereby represents as follows:

Daytime Telephone Number. State: Zip:

Examples of Daytime Telephone Number in a sentence

• No:________________ Home Address ___________________________________________________________________ City_____________________State _____________________________Zip_________________ Date of Birth _____________________________ Daytime Telephone Number _____________Evening Telephone Number _________________ |_| Please check box if your address has changed within the last year.

• Name: (please print) Capacity: Address: (City, State, Zip Code (Intl: Province, Postal Code)) Daytime Telephone Number: ( ) SIGNATURE GUARANTEE (Required only in cases specified in Instruction 4) The undersigned hereby guarantees the signature of the MC Member which appears on this Letter of Transmittal.

• Date (mm/dd/yyyy) Daytime Telephone Number * For sales requests for partnerships or corporations, please have your signature(s) medallion guaranteed or provide us with a certified copy of the corporate resolution dated within 180 days or a certified copy of the partnership agreement dated within 60 days.

• Authorized Signature Signer’s Name (print) Daytime Telephone Number and Ext.

• Trading Partner: Authorized Signature: Title of Authorized Signatory: Date: Address: City: State: ZIP +4: Phone: Remittance Address: Indiana State Department of Health Office of HIPAA Compliance EDI Division 3K ▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ ▇▇▇-▇▇▇-▇▇▇▇ Name: Daytime Telephone Number: State Form 53788 (12-08) Approved by Auditor of State, 2008 Approved by State Board of Accounts, 2008 Legal Name (OWNER OF THE EIN OR SSN AS NAME APPEARS ON YOUR TAX RETURN.

• Very truly yours, Dated: _________, 2018 By: Signature Its: Print Title (if applicable) Address (at the State of Domicile): Daytime Telephone Number: Email: Daytime Fax Number: Rule 501.

• Name of Limited Partner(s) Address City State Zip Daytime Telephone Number (For purposes of this request only) B - REDEMPTION RIGHT REQUEST Redemption Request (Check one) Full Redemption Partial Redemption # of Units or $ Amount C- AUTHORIZED SIGNATURE(S) AND MEDALLION SIGNATURE GUARANTEE REQUIREMENTS IMPORTANT: Medallion Signature Guarantee(s) is/are required if any of the following applies:The amount of the redemption request is over $500,000.

• Beneficial Owner’s Name (as it appears on your brokerage statement) Joint Beneficial Owner’s Name (as it appears on your brokerage statement) ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇ ▇▇▇▇ ▇▇▇▇▇ Zip Code Foreign Province Foreign Country ( ) ( ) Telephone Number (Daytime) Telephone Number (Evening) ( ) Fax Number E-Mail Address Record Owner’s Name and Address (if different from beneficial owner listed above) Claimant holder of Ormat common stock is: ¨ A.

• Please enter below: First Name Last Name Address Please provide the following personal identification information: Email address: City , State Zip ( ) ( ) Area Code Daytime Telephone Number Area Code Evening Telephone Number Last four digits of Social Security Number: Date of Birth: / / Month Day Year Other names used beginning 2004: I understand my entitlement to compensation will be determined exclusively by records of the Housing Authority of the City of Los Angeles (“HACLA”).

• Beneficial Owner’s Name (as it appears on your brokerage statement) Joint Beneficial Owner’s Name (as it appears on your brokerage statement) ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇ ▇▇▇▇ ▇▇▇▇▇ Zip Code Foreign Province Foreign Country ( ) ( ) Telephone Number (Daytime) Telephone Number (Evening) ( ) Fax Number E-Mail Address Record Owner’s Name and Address (if different from beneficial owner listed above) Claimant holder of Ormat common stock is: 🞎 A.

More Definitions of Daytime Telephone Number

Daytime Telephone Number. Evening Telephone Number: Email address (E-mail address is not required, but if you provide it you authorize the Claims Administrator to use it in providing you with information relevant to this claim.):

Daytime Telephone Number. Cell Phone Number: E-mail Address:

Daytime Telephone Number. X ___________________________Dated: ____________________________________________ Signature(s) of Owner(s) Must be signed by the registered holders(s) of the shares of ▇▇▇▇ ▇▇▇ common stock tendered as their names appear on the certificate(s) or on a security position listing or by person(s) authorized to become registered holder(s) by endorsements and documents transmitted with this Letter of Transmittal. If signed by a trustee, executor, administrator, guardian, attorney-in-fact, officer or other person acting in a fiduciary or representative apacity, please set forth the full title. See Instruction III in the Instructions to this Letter of Transmittal. Name(s): ________________________________ Capacity:_____________________________ (Please Print) Address: _______________________________________________________________________