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Name(s) and Addresses of Registered Holder(s)
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Shares of Series B
Preferred Stock Tendered* |
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Total
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*
Each share of Series B Preferred Stock is exchangeable in the Offer for one share of Series B1 Preferred Stock having a liquidation preference of $25.00 per share of Series B1 Preferred Stock plus an amount in cash equal to the accrued and unpaid dividends on the Series B Preferred Stock through the date of issuance of the Series B1 Preferred Stock
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X
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| | 2022 | |
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X
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| | 2022 | |
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X
Signature(s) of Holders
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Date
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| | 2022 | |
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Name of Firm:
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(Authorized signature)
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Address:
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Title:
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Name:
(Please type or print)
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(Zip Code)
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Date:
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