Common use of REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES Clause in Contracts

REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus and herein. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =============================================================================== Certificate Surrendered Original Notes Tendered Original Notes Accepted ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- Delivery Prepared by Checked by Date -------------- -------------- ------------ =============================================================================== IMPORTANT TAX INFORMATION Under federal income tax laws, a Holder whose tendered Original Notes are accepted for payment is required to provide the Exchange Agent (as payer) with such Hold▇▇'▇ ▇orrect TIN on Substitute Form W-9 below or otherwise establish a basis for exemption from backup withholding. If such Holder is an individual, the TIN is his social security number. If the Exchange Agent is not provided with the correct TIN, a $50 penalty may be imposed by the Internal Revenue Service, and payments made with respect to Original Notes purchased pursuant to the Exchange Offer may be subject to backup withholding. Certain Holders (including, among others, all corporations and certain foreign persons) are not subject to these backup withholding and reporting requirements. Exempt Holders should indicate their exempt status on Substitute Form W-9. A foreign person may qualify as an exempt recipient by submitting to the Exchange Agent a properly completed Internal Revenue Service Form W-8, signed under penalties of perjury, attesting to that Hold▇▇'▇ ▇xempt status. A Form W-8 can be obtained from the Exchange Agent. See the enclosed "Guidelines for Certification of Taxpayer Identification Number on Substitute Form W-9" for additional instructions. If backup withholding applies, the Exchange Agent is required to withhold 31% of any payments made to the Holder or other payee. Backup withholding is not an additional federal income tax. Rather, the federal income tax liability of persons subject to backup withholding will be reduced by the amount of tax withheld. If withholding results in an overpayment of taxes, a refund may be obtained from the Internal Revenue Service.

Appears in 1 contract

Sources: Letter of Transmittal (Nortek Inc)

REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests Requests for assistance and requests for or additional copies of the Prospectus or this Letter of Transmittal may be directed obtained from ▇▇▇▇▇ ▇▇▇▇▇, at ▇▇▇▇ ▇▇▇▇▇ ▇▇▇ & ▇▇▇▇▇▇▇▇, counsel to Parent, at (▇▇▇) ▇▇▇-▇▇▇▇. SUBSTITUTEFORM W-9 Department of the Exchange Agent at the address specified TreasuryInternal Revenue Service Payer’s Request for Taxpayer Identification Number Part 1 - Please provide your taxpayer identification number in the Prospectus and herein. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) =============================================================================== Certificate Surrendered Original Notes Tendered Original Notes Accepted ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- Delivery Prepared by Checked by Date -------------- -------------- ------------ =============================================================================== IMPORTANT TAX INFORMATION Under federal income tax laws, a Holder whose tendered Original Notes are accepted for payment is required to provide the Exchange Agent (as payer) with such Hold▇▇'▇ ▇orrect TIN on Substitute Form W-9 below or otherwise establish a basis for exemption from backup withholding. If such Holder is an individual, the TIN is his social security number. If the Exchange Agent is not provided with the correct TIN, a $50 penalty may be imposed by the Internal Revenue Service, and payments made with respect to Original Notes purchased pursuant to the Exchange Offer may be subject to backup withholding. Certain Holders (including, among others, all corporations and certain foreign persons) are not subject to these backup withholding and reporting requirements. Exempt Holders should indicate their exempt status on Substitute Form W-9. A foreign person may qualify as an exempt recipient by submitting to the Exchange Agent a properly completed Internal Revenue Service Form W-8, signed under penalties of perjury, attesting to that Hold▇▇'▇ ▇xempt status. A Form W-8 can be obtained from the Exchange Agentbox at right. See the enclosed "Guidelines for Certification of Taxpayer Identification Number on Substitute Form W-9" , below, for additional instructionsmore information on what number to enter. If backup withholding appliesSocial Security Number or Employer Identification Number __________________________ CHECK APPROPRIATE BOX FOR FEDERAL TAX CLASSIFICATION. □ Individual/sole proprietor □ Trust/estate □ C corporation □ S corporation □ Limited liability company □ Partnership□ Other __________________________________ CHECK APPROPRIATE BOX(ES) IF APPLICABLE. See the Guidelines for Certification of Taxpayer Identification Number on Substitute Form W-9, the Exchange Agent below, for more information. □ Exempt payee□ Awaiting Taxpayer Identification Number PLEASE fill in your name and address. Name Address Part 2 - certification Under penalties of perjury, I certify that: The number shown on this form is required my correct Taxpayer Identification Number (or I am waiting for a number to withhold 31% of any payments made be issued to the Holder or other payee. Backup withholding is me), and I am not an additional federal income tax. Rather, the federal income tax liability of persons subject to backup withholding will be reduced because: (a) I am exempt from backup withholding, or (b) I have not been notified by the amount Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and I am a U.S. citizen or other U.S. person, including a U.S. resident alien. You must cross out item 2 above if you have been notified by the IRS that you are subject to backup withholding because you have failed to report all interest and dividends on your tax withheldreturn and 2(c) does not apply to you. The Guidelines for Certification of Taxpayer Identification Number on Substitute Form W-9, below, include the applicable definition of “U.S. person.” The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. Signature __________________________________ Date _____________ Exhibit G-12 CERTIFICATE OF AWAITING TAXPAYER IDENTIFICATION NUMBER I certify under penalties of perjury that a taxpayer identification number has not been issued to me, and either (a) I have mailed or delivered an application to receive a taxpayer identification number to the appropriate Internal Revenue Service Center or Social Security Administration Office or (b) I intend to mail or deliver an application in the near future. I understand that, notwithstanding the information I provided in Part 2 of the Substitute Form W-9 (and the fact that I have completed this Certificate of Awaiting Taxpayer Identification Number), 28 percent of all payments made to me pursuant to this Offer to Purchase shall be retained until I provide a Tax Identification Number to the payer and that, if I do not provide my Taxpayer Identification number within sixty (60) days, such retained amounts shall be remitted to the IRS as backup withholding. Signature __________________________________ Date _____________ Use Internal Revenue Service Form W-9 (available online at ▇▇▇.▇▇▇.▇▇▇) or the Substitute Form W-9 included in this Letter of Transmittal to (1) provide your correct taxpayer identification number to the payer, (2) certify that the taxpayer information number you are giving is correct (or you are waiting for a number to be issued), (3) certify that you are not subject to backup withholding, or (4) claim exemption from backup withholding. GUIDELINES FOR DETERMINING WHETHER YOU ARE A U.S. PERSON-For U.S. federal tax purposes, you are considered a U.S. person if you are: (a) an individual who is a U.S. citizen or U.S. resident alien, (b) a partnership, corporation, company, or association created or organized in the U.S. or under the laws of the U.S., (c) an estate (other than a foreign estate), or (d) a domestic trust (as defined in Treasury Regulations section 301.7701-7). Resident aliens may be subject to special rules. Such stockholders should consult a tax advisor to determine their taxpayer identification number and the applicability of certain treaty benefits to them. If withholding results in an overpayment you are not a U.S. person, do not complete Internal Revenue Service Form W-9 or the Substitute Form W-9. Instead, use the appropriate Internal Revenue Service Form W-8 (a copy of taxes, a refund which may be obtained from the Depositary or online at ▇▇▇.▇▇▇.▇▇▇). Internal Revenue ServiceService Form W-8BEN is the version of the Internal Revenue Service Form W-8 that is most likely to apply to non-U.S. stockholders claiming an exemption from backup withholding, but all non-U.S. stockholders should consult a tax advisor to determine which Internal Revenue Service Form W-8 is appropriate. GUIDELINES FOR DETERMINING THE PROPER IDENTIFICATION NUMBER TO GIVE THE PAYER IN PART 1-Social Security numbers have nine digits separated by two hyphens: i.e., Exhibit G-13 000-00-0000. Employer identification numbers have nine digits separated by only one hyphen: i.e., 00-0000000. The table below will help determine the number to give the payer. 1. An individual’s account The individual 2. Joint account of two or more individuals The actual owner of the account or, if combined funds, the first individual on the account(1) 3. Custodian account of a minor (Uniform Gift to Minors Act) The minor(2) 4. a. The usual revocable savings trust account (grantor is also trustee) The grantor-trustee(1)

Appears in 1 contract

Sources: Agreement and Plan of Merger (Merit Medical Systems Inc)

REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests for assistance and requests for additional copies of the Prospectus or this Letter of Transmittal may be directed to the Exchange Agent at the address specified in the Prospectus and herein. Holders may also contact their broker, dealer, commercial bank, trust company or other nominee for assistance concerning the Exchange Offer. (DO NOT WRITE IN SPACE BELOW) ================================================================================ Certificate Surrendered Original Notes Tendered Original Notes Accepted ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Delivery Prepared by By_______________ Checked by Date -------------- -------------- ------------ By_______________ Date______________ ================================================================================ IMPORTANT TAX INFORMATION Under federal income tax laws, a Holder whose tendered Original Notes are accepted for payment is required to provide the Exchange Agent (as payer) with such Hold▇▇'▇ ▇orrect Holder's correct TIN on Substitute Form W-9 below or otherwise establish a basis for exemption from backup withholding. If such Holder is an individual, the TIN is his social security number. If the Exchange Agent is not provided with the correct TIN, a $50 penalty may be imposed by the Internal Revenue Service, and payments made with respect to Original Notes purchased pursuant to the Exchange Offer may be subject to backup withholding. Certain Holders (including, among others, all corporations and certain foreign persons) are not subject to these backup withholding and reporting requirements. Exempt Holders should indicate their exempt status on Substitute Form W-9. A foreign person may qualify as an exempt recipient by submitting to the Exchange Agent a properly completed Internal Revenue Service Form W-8, signed under penalties of perjury, attesting to that Hold▇▇'▇ ▇xempt Holder's exempt status. A Form W-8 can be obtained from the Exchange Agent. See the enclosed "Guidelines for Certification of Taxpayer Identification Number on Substitute Form W-9" for additional instructions. If backup withholding applies, the Exchange Agent is required to withhold 3120% of any payments made to the Holder or other payee. Backup withholding is not an additional federal income tax. Rather, the federal income tax liability of persons subject to backup withholding will be reduced by the amount of tax withheld. If withholding results in an overpayment of taxes, a refund may be obtained from the Internal Revenue Service.. PURPOSE OF SUBSTITUTE FORM W-9 To prevent backup withholding on payments made with respect to the Exchange Offer, the Holder is required to provide the Exchange Agent with either: (i) the Holder's correct TIN by completing the form below, certifying that the TIN provided on Substitute Form W-9 is correct (or that such Holder is awaiting a TIN) and that (A) the Holder has not been notified by the Internal Revenue Service that the Holder is subject to backup withholding as a result of failure to report all interest or dividends or (B) the Internal Revenue Service has notified the Holder that the Holder is no longer subject to backup withholding; or (ii) an adequate basis for exemption. WHAT NUMBER TO GIVE THE EXCHANGE AGENT The Holder is required to give the Exchange Agent the TIN (e.g., social security number or employer identification number) of the registered Holder of the Original Notes. If the Original Notes are held in more than one name or are held not in the name of the actual owner, consult the enclosed "Guidelines for Certification of Taxpayer Identification Number on Substitute Form W-9" for additional guidance on which number to report. The Exchange Agent for the Exchange Offer is: FLEET NATIONAL BANK

Appears in 1 contract

Sources: Letter of Transmittal (Icon Fitness Corp)

REQUESTS FOR ASSISTANCE OR ADDITIONAL COPIES. Questions and requests relating to the procedure for assistance and tendering, as well as requests for additional copies of the Prospectus or this Letter of Transmittal Letter, may be directed to the Exchange Agent at the address specified in the Prospectus and hereinAgent. Holders may also contact their brokerIMPORTANT: THIS LETTER (OR FACSIMILE THEREOF), dealerTOGETHER WITH CERTIFICATES OR CONFIRMATION OF BOOK-ENTRY TRANSFER AND ALL OTHER REQUIRED DOCUMENTS, commercial bankMUST BE RECEIVED BY THE EXCHANGE AGENT, trust company OR THE NOTICE OF GUARANTEED DELIVERY MUST BE RECEIVED BY THE EXCHANGE AGENT, ON OR PRIOR TO 5:00 P.M., NEW YORK CITY TIME, ON THE EXPIRATION DATE. - 10 - 11 REQUEST FOR TAXPAYER IDENTIFICATION NUMBER AND CERTIFICATION SUBSTITUTE FORM W-9 DEPARTMENT OF THE TREASURY, INTERNAL REVENUE SERVICE Please provide your social security number or other nominee taxpayer identification number on this Substitute Form W-9 and certify therein that you are not subject to backup withholding. Failure to complete and return this form may result in backup withholding of 31% of any payments made to you. For assistance, see the enclosed Instructions for assistance concerning the Exchange OfferSubstitute Form W-9. (DO NOT WRITE IN SPACE BELOW) ================================================================================ Certificate Surrendered Original Name(s) as shown above of registered owners of 11% Senior Secured Notes Tendered Original Notes Accepted ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- ------------------------- --------------------------- ------------------------- Delivery Prepared by Checked by Date -------------- -------------- ------------ =============================================================================== IMPORTANT TAX INFORMATION Under federal income tax laws(if joint ownership, a Holder list first and circle the name of the person or entity whose tendered Original Notes are accepted taxpayer identification number you enter in Part I below). -------------------------------------------------------------------------------- Business Name (sole proprietors, see enclosed Instructions for payment is required to provide the Exchange Agent (as payerSubstitute FORM W-9) with such Hold▇▇'▇ ▇orrect TIN on Substitute Form W-9 below or otherwise establish a basis for exemption from backup withholding. If such Holder is an individual, the TIN is his social security number. If the Exchange Agent is not provided with the correct TIN, a $50 penalty may be imposed by the Internal Revenue Service, and payments made with respect to Original Notes purchased pursuant to the Exchange Offer may be subject to backup withholding. Certain Holders (including, among others, all corporations and certain foreign persons) are not subject to these backup withholding and reporting requirements. Exempt Holders should indicate their exempt status on Substitute Form W-9. A foreign person may qualify as an exempt recipient by submitting to the Exchange Agent a properly completed Internal Revenue Service Form W-8, signed under penalties of perjury, attesting to that Hold▇▇'▇ ▇xempt status. A Form W-8 can be obtained from the Exchange Agent. See the enclosed "Guidelines for Certification of Taxpayer Identification Number on Substitute Form W-9" for additional instructions. If backup withholding applies, the Exchange Agent is required to withhold 31% of any payments made to the Holder or other payee. Backup withholding is not an additional federal income tax. Rather, the federal income tax liability of persons subject to backup withholding will be reduced by the amount of tax withheld. If withholding results in an overpayment of taxes, a refund may be obtained from the Internal Revenue Service.-------------------------------------------------------------------------------- Address:

Appears in 1 contract

Sources: Exchange Offer (Lamar Advertising Co)