11630. Due-Bills and Due-Bill Checks
• • • Supplementary Material: --------------
.01 Sample Due-Bills Form.
For value received, the undersigned hereby assigns, transfers and sets over to __________________________________ the stock distribution of ______ ( ) shares of _____________________ stock of ______________________________ to be issued on ___________________ to the registered holder of ___________ ( ) shares of _________________ stock of ___________________ represented by certificate number ___________________ , to which the undersigned is entitled as a stock dividend, and hereby irrevocably constitutes and appoints __________________________________ attorney to transfer the shares representing said stock dividend on the books of said corporation, with full power of substitution in the premises. |
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_________________________________ (Date) |
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_________________________________ (Official Signature) |
For value received, the undersigned hereby assigns, transfers, and sets over to _____________________________________________________ the warrant and/or fractional warrant to which the undersigned is entitled, evidencing the rights to subscribe for _____________________ _________________________ , which warrant and/or fractional warrant is to be issued to the holder of record at the close of business _________________________ of ______________ ( ) shares of ________________________ stock of _______________________ represented by certificate No. _________________ |
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_________________________________ (Date) |
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_________________________________ (Official Signature) |
This is to certify that, upon issuance of _______________________ in accordance with the plan approved by _________________________ , the undersigned will pay to ______________________________________ $ __________ representing (contingent)(income) interest for ___________ on $ _____ principal amount of said bonds sold to it when, as, and if issued on _____ 20 _____ This due-bill shall become null and void if the contract for sale of said bonds can not be completed in accordance with the plan approved by ___ , on _______________________ |
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_________________________________ (Date) |
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_________________________________ (Official Signature) |
This is to certify that, upon issuance of _____________________ in accordance with the plan approved by _________________________ , the undersigned will pay to _______________________ $ _____ , representing the dividend of $ _____ per share declared for the period ending 20 _____ , on _____________ shares of _______________________ stock of ____ sold to it when, as, and if issued on _______________________ 20 _____ This due-bill shall become null and void if the contract for sale of said stock cannot be completed in accordance with the plan approved by ____ , on _________________________ |
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_________________________________ (Date) |
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_________________________________ (Official Signature) |
NEW YORK _________________ , X Y Z BANK |
20 _____ |
No. 1999 1-2 ___ 210 |
Pay To The Order Of__________________________________________________ | ||
$ __________________________________________________ |
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Dollars | ||
In Payment of Dividend or Interest |
Dividend Account – Interest Account – |
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On ____________________________________ |
NOT PAYABLE BEFORE ____________________________________ |
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RECORD DATE__________________________________________ |
Amended by SR-FINRA-2010-030 eff. Dec. 15, 2010. Amended eff. Feb. 21, 1969; Mar. 1, 1970; Nov. 1, 1971; Nov. 1, 1972; Mar. 18, 1983. Selected Notices: 83-69, 10-49. |