TVIN » Topics » [Form of Notice of Exercise]

This excerpt taken from the TVIN 10-Q filed Nov 26, 2008.

[Form of Notice of Exercise]

 

Date:              

 

TO: TVI Corporation (the “Company”)

 

RE: Election to Purchase Common Stock

 

The undersigned, pursuant to the provisions set forth in the attached Warrant, hereby subscribes for and purchases the number of shares of the Common Stock set forth below covered by such Warrant, or for all of the shares issuable on the date hereof upon exercise of such Warrant if this Notice of Exercise does not specify the number of shares of Common Stock for which the undersigned so subscribes and purchases. The undersigned, in accordance with Section 3 of the Warrant, hereby agrees to pay the aggregate Exercise Price for such shares of Common Stock in the manner set forth below.  To the extent that the Exercise Price A new warrant evidencing the remaining shares of Common Stock covered by such Warrant, but not yet subscribed for and purchased, if any, should be issued in the name set forth below.

 

Number of Shares of Common Stock:

 

Method of Payment of Exercise Price:

 

(Check the appropriate box below to indicate method of payment of Exercise Price.  If no box is checked, then such Warrant shall be deemed to have been exercised pursuant to Section 3(ii) of Such Warrant; provided, however, that no exercise of such Warrant shall be effective unless and until the Company has received payment in full, in the manner prescribed by Section 3(ii) of such Warrant, of the aggregate Exercise Price payable with respect to the number of shares of Common Stock subscribed for and purchased by this Notice of Exercise.)

 

o                                   Cashless exercise pursuant to Section 3(i) of such Warrant; or

 

Note:                  If the undersign indicates “cashless exercise” pursuant to Section 3(i) of such Warrant, then the Warrant shall not be effective unless and until consent of the Company to such method of payment is indicated by execution of this Notice of Exercise on behalf of the Company in the space provided below, unless such consent of the Company is not required by Section 3(i) of such Warrant.

 

o                                   Cash exercise pursuant to Section 3(ii) of such Warrant.

 

[Signature page follows]

 

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The undersigned hereby represents that the undersigned is an “accredited investor” as defined in Regulation D under the Securities Act of 1933, as amended.

 

Holder:

 

 

By:

 

 

Name:

 

 

Title:

 

 

 

 

[Consent by the Company to “Cashless Exercise” of such Warrant pursuant to Section 3(i) of such Warrant (to the Extent Required by Section 3(i) of such Warrant):

TVI CORPORATION

 

By:

 

 

Name:

 

 

Title:

 

]

 

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