| | |
THE OFFER AND WITHDRAWAL RIGHTS WILL EXPIRE AT MIDNIGHT (AT THE END OF THE DAY), EASTERN STANDARD TIME, ON DECEMBER 21, 2021, OR SUCH LATER TIME AND DATE TO WHICH WE MAY EXTEND.
|
| |
| |
By Mail:
|
| |
By Overnight Courier:
|
|
| |
Computershare Trust Company, N.A.
c/o Voluntary Corporate Actions P.O. Box 43011 Providence, Rhode Island 02940-3011 |
| |
Computershare Trust Company, N.A.
c/o Voluntary Corporate Actions 150 Royall Street, Suite V Canton, Massachusetts 02021 |
|
| | |
ACCOUNT NUMBER
|
| | |
BOOK SHARES
|
| | |
ISSUE NUMBER
|
| |
| | | | | | | | | | | | | |
| | |
FOR OFFICE USE ONLY Approved W-9 Completed
|
| | ||||||||
| | |
DESCRIPTION OF SHARES TENDERED
(SEE INSTRUCTIONS 3 AND 4) |
| | ||||||||
| | |
NAME(S) AND ADDRESS(ES) OF REGISTERED HOLDER (S)
(PLEASE FILL IN, IF BLANK, EXACTLY AS NAME(S) APPEAR(S) ON ACCOUNT STATEMENT) |
| | |
PREFERRED SHARES TENDERED
(ATTACH ADDITIONAL SIGNED LIST, IF NECESSARY) |
| | ||||
| | | | | | | | | | ||||
| |
Total Shares of Series A Preferred Stock Tendered
|
| | | | | | |||||
| | |
SPECIAL DELIVERY INSTRUCTIONS
To be completed ONLY if the check for the aggregate Purchase Price of Series A Preferred Shares purchased and/or certificates or book-entries for Series A Preferred Shares 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:
Name:
(please print)
|
| | |
SPECIAL PAYMENT INSTRUCTIONS
(See Instructions 1, 5, 6 and 7)
To be completed ONLY if the check for payment of the Purchase Price of Series A Preferred Shares accepted for payment are to be issued in the name of someone other than the undersigned or if you wish to receive a wire. If you wish to receive a wire please include the Wire Transfer Form in your return packet to Computershare.
Issue:
Name:
(please print)
|
| |
| | | Address: | | | | Address: | | |
| | |
(please include Zip Code)
|
| | |
(please include Zip Code)
|
| |
| | |
IMPORTANT: STOCKHOLDERS SIGN HERE
(also please complete IRS Form W-9 or the appropriate IRS Form W-8)
Signature(s) of Owner(s):
|
| | ||||
| | |
Dated:
|
| | ||||
| | |
(Must be signed by registered holder(s) exactly as name(s) appear(s) on the transfer agent’s records or by person(s) authorized to become registered holder(s) of such shares as evidenced by endorsement or stock powers transmitted herewith. If signed by a trustee, executor, administrator, guardian, attorney-in-fact, officer of a corporation or other person acting in a fiduciary or representative capacity, the full title of the person should be set forth. See Instruction 5).
Name(s):
(Please Print)
Capacity (full title):
Address:
(Include Zip Code)
Name of Firm:
(Include Zip Code)
Authorized Signature:
Name:
(Please Type or Print)
Area Code and Telephone Number:
Dated: , 2021
NOTE: A notarization by a notary public is not acceptable.
PLACE MEDALLION GUARANTEE IN SPACE BELOW |
| | ||||
| |
By Mail:
|
| |
By Overnight Courier:
|
|
| |
Computershare Trust Company, N.A.
c/o Voluntary Corporate Actions P.O. Box 43011 Providence, Rhode Island 02940-3011 |
| |
Computershare Trust Company, N.A.
c/o Voluntary Corporate Actions 150 Royall Street, Suite V Canton, Massachusetts 02021 |
|