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THE OFFER, PRORATION PERIOD AND WITHDRAWAL RIGHTS WILL EXPIRE AT 5:00 P.M.,
NEW YORK CITY TIME, ON JUNE 30, 2021, UNLESS THE OFFER IS EXTENDED OR WITHDRAWN (SUCH DATE, AS IT MAY BE EXTENDED, THE “EXPIRATION DATE”). |
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If delivering by express mail,
courier or other expedited service: |
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By first class, certified or registered mail: |
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Broadridge Corporate Issuer Solutions, Inc.
Attn: BCIS IWS 51 Mercedes Way Edgewood, NY 11717 |
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Broadridge Corporate Issuer Solutions, Inc.
Attn: BCIS Re-Organization Department PO Box 1342 Brentwood, NY 11717-0718 |
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DESCRIPTION OF SHARES OF CLASS A COMMON STOCK TENDERED
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Name(s) and
Address(es) of Registered Holder(s) |
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Shares of Class A Common Stock Tendered (attach additional list if necessary)
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(Please fill in. Attach separate schedule if needed — See Instruction 3)
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Certificated Shares of Class A Common Stock**
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Book-Entry
Shares of Class A Common Stock*** |
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Certificate No(s)*
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Total number of Shares
of Class A Common Stock Represented by Certificate(s)* |
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Number of Shares
of Class A Common Stock Tendered** |
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Number of
Shares of Class A Common Stock Tendered*** |
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TOTAL SHARES OF
CLASS A COMMON STOCK |
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| | 1st: | | | 2nd: | | | 3rd: | |
| | 4th: | | | 5th: | | | | |
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☐ $1.50
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☐ $1.60
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☐ $1.70
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☐ $1.80
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☐ $1.90
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☐ $2.00
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(See Instructions 1, 6, 7 and 8)
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| | | To be completed ONLY if the check for the aggregate Purchase Price of shares of Class A Common Stock purchased and/or certificates for shares of Class A Common Stock not tendered or not purchased are to be mailed to someone other than the undersigned or to the undersigned at an address other than that shown below the undersigned’s signature. | | |
| | Mail: | | | ☐ Check | | | | |
| | | | | ☐ Certificate(s) to: | | | | |
| | Name: | | |
(Please Print)
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| | Address: | | |
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(Please Include Zip Code)
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(Taxpayer Identification or Social
Security Number) |
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(Taxpayer Identification or Social
Security Number) |
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| | Mail: | | | ☐ Check | | | | |
| | | | | ☐ Certificate(s) to: | | | | |
| | Name: | | |
(Please Print)
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| | Address: | | |
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(Please Include Zip Code)
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(Taxpayer Identification or Social
Security Number) |
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(Taxpayer Identification or Social
Security Number) |
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| Area Code and Telephone Number: |
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If delivering by express mail,
courier or other expedited service: |
| |
By first class, certified or registered mail: |
|
| |
Broadridge Corporate Issuer Solutions, Inc.
Attn: BCIS IWS 51 Mercedes Way Edgewood, NY 11717 |
| |
Broadridge Corporate Issuer Solutions, Inc.
Attn: BCIS Re-Organization Department PO Box 1342 Brentwood, NY 11717-0718 |
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