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FORM OF BENEFICIAL OWNER ELECTION FORM

I (we) acknowledge receipt of your letter and the enclosed materials relating to the offering of rights (the “Class C Rights”) to purchase Class C common shares, par value $0.01 per share (the “Class C Common Shares”), of Liberty Latin America Ltd. (the “Company”).

In Part I of this form, I (we) instruct you whether to exercise, sell or transfer the Class C Rights distributed pursuant to the terms and subject to the conditions set forth in the prospectus dated September 10, 2020.

PART I

 

BOX 1.		☐		Please do not exercise Class C Rights.
BOX 2.		☐		Please exercise Class C Rights as set forth below:

 

Number of Class C Rights

Subscription Price

Payment

Basic Subscription Privilege:

x

$

7.14

=

$

(Line 1)

Oversubscription Privilege:

x

$

7.14

=

$

(Line 2)

By exercising the oversubscription privilege (the “Oversubscription Privilege”) with respect to my (our) Class C Rights, I (we) hereby represent and certify that I (we) have fully exercised my (our) basic subscription privilege (the “Basic Subscription Privilege”) received in respect of Class C common shares held in the below described capacity.

Total Payment Required = $______________

(Sum of Lines 1 and 2 must equal total of amounts in Boxes 3 and 4)

 

BOX 3.		☐		Payment in the following amount is enclosed: ______________
BOX 4.		☐		Please deduct payment from the following account maintained by you as follows:

 

Type of Account						Account No:
Amount to be deducted:  $___________________						Signature:
Date: ______________, 2020						Signature:
								(If held jointly)

 

BOX 5.		☐		Please sell __________________of my Class C Rights.
BOX 6.		☐		Please have Computershare N.A. effect my specific instructions that I have attached hereto and for which I have had an Eligible Institution guarantee my signature.

 

 

Please type or print name(s) below:
Signature(s) Guaranteed by:
Eligible Institution

 

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