TO SUBSCRIBE. IF YOU WISH TO SUBSCRIBE FOR YOUR FULL ENTITLEMENT: A. Primary Subscription x $ 7.00 = $ __________________________ _______________ ________________ (No. of New Shares) (price per share) (Amount Enclosed) B. I apply for the Over-Subscription Election (You can only subscribe if you have fully exercised your Primary Subscription rights. A record holder who holds as nominee for a beneficial owner may subscribe if the beneficial owner has exercised such owner's full Primary Subscription rights and a Nominee Holder Certification in the form accompanying this Subscription Certificate is completed as to such beneficial owner.) x $ 7.00 = $ __________________________ _______________ ________________ (No. of New Shares) (price per share) (Amount Enclosed) IF YOU WISH TO APPLY FOR LESS THAN YOUR FULL ENTITLEMENT: C. I apply for less than the full entitlement x $ 7.00 = $ __________________________ _______________ ________________ (No. of New Shares) (price per share) (Amount Enclosed) I acknowledge that I have received the Prospectus for the Rights Offering and I hereby irrevocably subscribe for the number of shares indicated above as a total of A and B or C above, on 5 the terms and conditions specified in the Prospectus relating to the Primary Subscription and the Over-Subscription Election. Signature of subscriber(s)______________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Telephone number (including area code) ( )___________________________ ________________________________________________________________________________ ________________________________________________________________________________ *Signature Guaranteed By: _______________________________ *If you wish to have your shares and refund check (if any) delivered to an address other than that listed on this Subscription Certificate, you must have your signature guaranteed by an eligible guarantor institution (banks, stock brokers, savings and loan associations, and credit unions) with membership in an approved signature guarantee medallion program pursuant to SEC Rule 17Ad-15. Please provide the delivery address below and note if it is a permanent change. ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________
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TO SUBSCRIBE. IF YOU WISH TO SUBSCRIBE FOR YOUR FULL ENTITLEMENT:
A. Primary Subscription x $ 7.00 = $ __________________________ _______________ ________________ (No. of New Shares) (price per share) (Amount Enclosed)
B. I apply for the Over-Subscription Over_Subscription Election (You can only subscribe if you have fully exercised your Primary Subscription rights. A record holder who holds as nominee for a beneficial owner may subscribe if the beneficial owner has exercised such owner's full Primary Subscription rights and a Nominee Holder Certification in the form accompanying this Subscription Certificate is completed as to such beneficial owner.) x $ 7.00 = $ __________________________ _______________ ________________ (No. of New Shares) (price per share) (Amount Enclosed) IF YOU WISH TO APPLY FOR LESS THAN YOUR FULL ENTITLEMENT:
C. I apply for less than the full entitlement x $ 7.00 = $ __________________________ _______________ ________________ (No. of New Shares) (price per share) (Amount Enclosed) I acknowledge that I have received the Prospectus for the Rights Offering and I hereby irrevocably subscribe for the number of shares indicated above as a total of A and B or C above, on 5 the terms and conditions specified in the Prospectus relating to the Primary Subscription and the Over-Subscription Election. Signature of subscriber(s)______________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Telephone number (including area code) ( )___________________________ ________________________________________________________________________________ ________________________________________________________________________________ *Signature Guaranteed By: _______________________________ *If you wish to have your shares and refund check (if any) delivered to an address other than that listed on this Subscription Certificate, you must have your signature guaranteed by an eligible guarantor institution (banks, stock brokers, savings and loan associations, and credit unions) with membership in an approved signature guarantee medallion program pursuant to SEC Rule 17Ad-15. Please provide the delivery address below and note if it is a permanent change. ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________
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