PLEASE INSERT SOCIAL. SECURITY OR TAX IDENTIFICATION NUMBER OF HOLDER Signature Guaranteed: _______________________________ EXHIBIT A --------- FORM OF RESTRICTED STOCK LETTER THE UNDERSIGNED (hereinafter referred to as "PURCHASER") is exercising the Non-Qualified Stock Option tendered with this Restricted Stock Letter, and in connection with such exercise, makes the following representations and warranties to Research Engineers, Inc. (the "COMPANY") with the knowledge and intent that the Company shall be entitled to rely thereon in delivering shares of the Company's Common Stock ("SHARES") to Purchaser upon exercise of the Non-Qualified Stock Option:
PLEASE INSERT SOCIAL. SECURITY OR TAX IDENTIFICATION NUMBER OF HOLDER Signature Guaranteed: ________________________________ EXHIBIT A --------- FORM OF RESTRICTED STOCK LETTER THE UNDERSIGNED (hereinafter referred to as "PURCHASER") is exercising the Non-Qualified Stock Option tendered with this Restricted Stock Letter, and in connection with such exercise, makes the following representations and warranties to Telenetics Corporation (the "COMPANY") with the knowledge and intent that the Company shall be entitled to rely thereon in delivering shares of the Company's Common Stock ("SHARES") to Purchaser upon exercise of the Non-Qualified Stock Option:
PLEASE INSERT SOCIAL. SECURITY ___________________________ OR OTHER IDENTIFYING NUMBER NOTICE: The signature to this assignment OF ASSIGNEE must correspond with the name as it appears upon the face of the within Note in every ______________________________ particular, without any alteration whatsoever. SIGNATURE GUARANTEED: ------------------------------
Examples of PLEASE INSERT SOCIAL in a sentence
FOR VALUE RECEIVED, the undersigned hereby sell(s), assign(s) and transfer(a) unto: PLEASE INSERT SOCIAL SECURITY NUMBER OR OTHER IDENTIFYING NUMBER OF ASSIGNEE (Please print or typewrite name and address, including postal zip code, of assignee) the within Security and all rights thereunder, and hereby irrevocably constitutes and appoints to transfer said Security on the books of the Company, with full power of substitution in the premises.
FORM OF TRANSFER FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE Please print or typewrite name and address of assignee the within Certificate and does hereby or irrevocably constitute and appoint to transfer the said Certificate in the Certificate Register of the within-named Trust, with full power of substitution in the premises.
Ex (a)-10 -------------------------------------------------------------------------------- FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE -------------------------------------- -------------------------------------- .................................................................................
FOR VALUE RECEIVED the undersigned hereby sells, assigns and transfers unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE (Please print or type name and address, including postal zip code, of assignee) the within Certificate, and all rights thereunder, hereby irrevocably constituting and appointing Attorney to transfer said Certificate on the books of the Certificate Registrar, with full power of substitution in the premises.
ASSIGNMENT FOR VALUE RECEIVED the undersigned hereby sells, assigns and transfers unto PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE (Please print or type name and address, including postal zip code, of assignee) the within Certificate, and all rights thereunder, hereby irrevocably constituting and appointing Attorney to transfer said Certificate on the books of the Certificate Registrar, with full power of substitution in the premises.
More Definitions of PLEASE INSERT SOCIAL
PLEASE INSERT SOCIAL. SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE ______________________________ Please print or typewrite name and address of assignee the within Certificate and does hereby or irrevocably constitute and appoint to transfer the said Certificate in the Certificate Register of the within-named Trust, with full power of substitution in the premises. Dated:_________________________ _______________________________
PLEASE INSERT SOCIAL. SECURITY OR OTHER For value received, the undersigned hereby sells, assigns and transfers unto IDENTIFYING NUMBER OF ASSIGNEE [ ] ---------------------------------------------------------------------------- PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS OF ASSIGNEE ------------------------------------------------------------------------------------------------------------------- Shares ------------------------------------------------------------------------------------------------------------ represented by the within Certificate, and hereby irrevocably constitutes and appoints ---------------------------- Attorney to transfer the said ------------------------------------------------------------------------------------- shares on the books of the within-named Corporation with full power of substitution in the premises. Dated, ------------------------------ In presence of ----------------------------------- ----------------------------------- 89 [BLUMBERG'S LAW PRODUCTS LETTERHEAD] STOCK POWER FOR VALUE RECEIVED, Michxxx X. Xxxxxx ------------------------------------------------------------- PLEASE INSERT SOCIAL SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE herexx xxxx, xxsign and transfer unto [ ] -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- --------------------------------------------------------------------------------
PLEASE INSERT SOCIAL. SECURITY OR TAX IDENTIFICATION NUMBER (Please print name and address) __________________________________ __________________________________ __________________________________ If said number of Warrants shall not be all the Warrants evidenced by the foregoing Warrant Certificate, the undersigned requests that a new Warrant Certificate evidencing the Warrants not so exercised be issued in the name of and delivered to: ______________________________________________________________________________ ______________________________________________________________________________ (Please print name and address) By:______________________________ Name: Title: Dated: __________________ FORM OF ASSIGNMENT FOR VALUE RECEIVED, _____________________ hereby sells, assigns and transfers to each assignee set forth below all of the rights of the undersigned in and to the number of Warrants (as defined in and evidenced by the foregoing Warrant Certificate) set opposite the name of such assignee below and in and to the foregoing Warrant Certificate with respect to said Warrants and the shares of Common Stock issuable upon exercise of said Warrants: NAME OF ASSIGNEE ADDRESS NUMBER OF WARRANTS ---------------- ------- ------------------ If the total of said Warrants shall not be all the Warrants evidenced by the foregoing Warrant Certificate, the undersigned requests that a new Warrant Certificate evidencing the Warrants not so assigned be issued in the name of and delivered to the undersigned. By:______________________________ Name: Title: Dated: __________________ THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR ANY STATE SECURITIES LAWS AND MAY NOT BE TRANSFERRED, SOLD OR OTHERWISE DISPOSED OF EXCEPT WHILE SUCH A REGISTRATION IS IN EFFECT UNDER SUCH ACT AND APPLICABLE STATE SECURITIES LAWS OR PURSUANT TO AN EXEMPTION FROM REGISTRATION UNDER SUCH ACT OR SUCH LAWS. THE SECURITIES REPRESENTED BY THIS CERTIFICATE ARE ALSO SUBJECT TO CERTAIN RESTRICTIONS ON TRANSFERS SET FORTH IN A SHAREHOLDERS AGREEMENT, DATED AS OF AUGUST 20, 1997 (AS AMENDED, MODIFIED OR SUPPLEMENTED THROUGH THE DATE HEREOF, THE "SHAREHOLDERS AGREEMENT"), BY AND AMONG THE COMPANY AND THE SHAREHOLDERS NAMED THEREIN, A COPY OF WHICH IS AVAILABLE FOR INSPECTION AT THE OFFICES OF THE COMPANY. NO TRANSFER OF SUCH SECURITIES WILL BE MADE ON THE BOOKS OF THE COMPANY UNLESS ACCOMPANIED BY EVIDENCE OF COMPLIANCE WITH THE TERMS OF SUCH AGREEMENTS. EXE...
PLEASE INSERT SOCIAL. SECURITY OR TAX IDENTIFICATION NUMBER (Please print name and address) ________________________________ ________________________________ ________________________________ If said number of Warrants shall not be all the Warrants evidenced by the foregoing Warrant Certificate, the undersigned requests that a new Warrant Certificate evidencing the Warrants not so exercised be issued in the name of and delivered to: ________________________________________________________________________ ________________________________________________________________________ (Please print name and address) By:_________________________ Name: Title: Dated: __________________ FORM OF ASSIGNMENT FOR VALUE RECEIVED,_________________ hereby sells, assigns and transfers to each assignee set forth below all of the rights of the undersigned in and to the number of Warrants (as defined in and evidenced by the foregoing Warrant Certificate) set opposite the name of such assignee below and in and to the foregoing Warrant Certificate with respect to said Warrants and the shares of Common Stock issuable upon exercise of said Warrants: NAME OF ASSIGNEE ADDRESS NUMBER OF WARRANTS ---------------- ------------------------- ------------------ If the total of said Warrants shall not be all the Warrants evidenced by the foregoing Warrant Certificate, the undersigned requests that a new Warrant Certificate evidencing the Warrants not so assigned be issued in the name of and delivered to the undersigned.
PLEASE INSERT SOCIAL. SECURITY OR TAX I.D. NUMBER OF HOLDER ________________________________
PLEASE INSERT SOCIAL. SECURITY OR TAX IDENTIFICATION NUMBER OF HOLDER ASSIGNMENT (To be signed only upon assignment of Rights) FOR VALUE RECEIVED, the undersigned hereby sells, assigns and transfers to (Name and Address of Assignee) the within Certificate hereby irrevocably constituting and appointing _________________________ Attorney to transfer said Certificate on the books of the Company, with full power of substitution in the premises. DATED: ____________, _____ (The above signature must correspond in all respects to the name as written on the face of this Rights Certificate.) Signature Guaranteed: __________________________ SCHEDULE OF EXCHANGES OF DEFINITIVE RIGHTS2 The following exchanges of a part of this Global Right for definitive Rights have been made: Number of ANNEX B CERTIFICATE TO BE DELIVERED UPON EXCHANGE OR REGISTRATION OF TRANSFER OF RIGHTS Re: Common Stock Appreciation Rights ("Rights") of Terex Corporation This Certificate related to _____ Rights held in ** book-entry or * * definite form by _____ (the "Transferor"). The Transferor by written order, has requested the Rights Agent*: * to deliver, in exchange of its beneficial interest in the Global Right held by the depository, a Right or Rights in definitive, registered form of authorized denominations and an aggregate amount equal to its beneficial interest in such Global Right (or the portion thereof indicated above); or * to exchange or register the transfer of a Right or Rights. In connection with such request and in respect of each such Right, the Transferor does hereby certify that the Transferor is familiar with the Common Stock Appreciation Rights Agreement relating to such Rights and that the transfer of this Right is pursuant to an effective registration statement under the Securities Act of 1933, as amended (the "Securities Act') or does not require registration under the Securities Act because such Right: * is being acquired for the Transferor's own account, without transfer; * is being transferred pursuant to an effective registration statement; * is being transferred to a qualified institutional buyer (as defined in Rule 144A under the Securities Act), in reliance on such Rule 144A; * is being transferred pursuant to an exemption from registration in accordance with Rule 904 under the Securities Act;** * is being transferred pursuant to Rule 144 under the Securities Act;** * is being transferred pursuant to another exemption from the registration requirements of the Securities Act (explain:__...
PLEASE INSERT SOCIAL. SECURITY OR OTHER IDENTIFYING NUMBER OF ASSIGNEE: PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS INCLUDING POSTAL ZIP CODE OF ASSIGNEE: ________________________________________________________________________________ ______________________________________________________ the within Note and all rights thereunder, hereby irrevocably constituting and appointing ____________________________________________________ attorney to transfer said Note on the books of the Company, with full power of substitution in the premises. Dated: ------------------------------ ---------------------------------------- Signature Guaranty ------------------------------------- Signature Signatures must be guaranteed by an "eligible guarantor institution" meeting (Signature must correspond with the the requirements of the Registrar, which name as written upon the face of the requirements include membership or within instrument in every participation in the Security Transfer particular, without alteration or Agent Medallion Program ("STAMP") or enlargement or any change whatever.) such other "signature guarantee program" as may be determined by the Registrar in addition to, or in substitution for, STAMP, all in accordance with the Securities Exchange Act of 1934, as amended.