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THE OFFER AND WITHDRAWAL RIGHTS WILL EXPIRE AT THE END OF THE DAY,
ONE MINUTE FOLLOWING 11:59 P.M., EASTERN TIME, ON NOVEMBER 18, 2021, UNLESS THE OFFER IS EXTENDED OR EARLIER TERMINATED. |
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If delivering by mail:
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If delivering by hand, express mail, courier
or any other expedited service: |
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American Stock Transfer & Trust Company, LLC
Operations Center Attn: Reorganization Department 6201 15th Avenue Brooklyn, New York 11219 Phone: Toll-free (877) 248-6417 (718) 921-8317 Fax: 718 234-5001 |
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American Stock Transfer & Trust Company, LLC
Operations Center Attn: Reorganization Department 6201 15th Avenue Brooklyn, New York 11219 |
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| | Name(s) of Record Holder(s): | | |
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| | Number of Shares Tendered: | | |
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| | Certificate Number(s) (if available): | | |
(please print)
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| | Address(es): | | |
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(zip code)
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| | ☐ Check if securities will be tendered by book-entry transfer | | |||
| | Name of Tendering Institution: | | |
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Area Code and Telephone No.(s):
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| | Signature(s): | | |
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| | DTC Participant No.: | | |
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| | Transaction Code No.: | | |
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| | Dated: | | | | |
| | Name of Firm: | | |
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(zip code)
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| | Area Code and Tel. No.: | | |
(Authorized Signature)
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| | Name: | | |
(Please type or print)
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| | Title: | | |
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| | Dated: | | |
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