Attached files
| file | filename |
|---|---|
| S-1 - FORM S-1 - Alon USA Energy, Inc. | d75601sv1.htm |
| EX-4.4 - EX-4.4 - Alon USA Energy, Inc. | d75601exv4w4.htm |
| EX-4.3 - EX-4.3 - Alon USA Energy, Inc. | d75601exv4w3.htm |
| EX-4.5 - EX-4.5 - Alon USA Energy, Inc. | d75601exv4w5.htm |
| EX-99.2 - EX-99.2 - Alon USA Energy, Inc. | d75601exv99w2.htm |
| EX-21.1 - EX-21.1 - Alon USA Energy, Inc. | d75601exv21w1.htm |
| EX-99.5 - EX-99.5 - Alon USA Energy, Inc. | d75601exv99w5.htm |
| EX-99.4 - EX-99.4 - Alon USA Energy, Inc. | d75601exv99w4.htm |
| EX-99.7 - EX-99.7 - Alon USA Energy, Inc. | d75601exv99w7.htm |
| EX-99.3 - EX-99.3 - Alon USA Energy, Inc. | d75601exv99w3.htm |
| EX-24.1 - EX-24.1 - Alon USA Energy, Inc. | d75601exv24w1.htm |
| EX-12.1 - EX-12.1 - Alon USA Energy, Inc. | d75601exv12w1.htm |
| EX-23.1 - EX-23.1 - Alon USA Energy, Inc. | d75601exv23w1.htm |
| EX-99.1 - EX-99.1 - Alon USA Energy, Inc. | d75601exv99w1.htm |
Exhibit 99.6
FORM OF
BENEFICIAL OWNER ELECTION FORM
I (we) acknowledge receipt of your letter and the enclosed
materials referred to therein relating to the rights offering by
Alon USA Energy, Inc., a Delaware corporation (the
“Company”), of subscription rights distributed to the
stockholders of record of common stock of the Company as of the
close of business, New York City time,
on ,
2010 (the “Record Date”) to purchase shares of the
Company’s 8.75% Series A Convertible Preferred Stock,
par value $0.01 per share (“Series A Preferred
Stock”). The Rights are described in detail in the
Company’s prospectus
dated ,
2010, (the “Prospectus”).
With respect to any instructions to sell or otherwise
transfer your subscription rights, the undersigned acknowledges
that this form must be completed and returned such that it will
actually be received by you by 6:00 p.m., New York City
time,
on ,
2010, the fifth business day prior to the scheduled expiration
date of the rights offering
of ,
2010, which may be extended by the Company in its sole
discretion. With respect to any instructions to exercise (or not
to exercise) the subscription rights, the undersigned
acknowledges that this form must be completed and returned such
that it will actually be received by you by 6:00 p.m., New
York City time,
on ,
2010, the last business day prior to the scheduled expiration
date of the rights offering
of ,
2010, which may be extended by the Company in its sole
discretion.
This will instruct you whether to exercise subscription rights
to purchase shares of the Series A Preferred Stock with
respect to the common stock held by you for the account of the
undersigned, pursuant to the terms and subject to the conditions
set forth in the Prospectus and the Instructions for Completion
of Alon USA Energy, Inc. Rights Certificates.
| I (we) hereby instruct you as follows: | ||
| (CHECK THE APPLICABLE BOXES AND PROVIDE ALL REQUIRED INFORMATION) | ||
|
o
|
Please exercise my (our) subscription rights for shares of Series A Preferred Stock as set forth below: |
The number of subscription rights for which the undersigned
gives instructions for exercise under the basic subscription
right should not exceed the number of subscription rights that
the undersigned is entitled to exercise.
|
Number of |
||||||||||||
|
Shares of Series A |
||||||||||||
| Preferred Stock | Exercise Price | Payment | ||||||||||
|
Basic Subscription Right
|
× | $10 = | $ | (Line 1) | ||||||||
|
Over-Subscription Right
|
× | $10 = | $ | (Line 2) | ||||||||
|
Total Payment Required
|
$ | |||||||||||
|
(Sum of Lines 1 and 2; must equal total of amounts in Boxes 2 and 3.) |
||||||||||||
|
I am (we are) making the total purchase price payment required
in the following manner:
|
||||||
|
Box 3
|
o | Payment in the following amount is enclosed: $ ; or | ||||
|
Box 4
|
o | Please deduct payment of $ from the following account maintained by you as follows: | ||||
| Type of Account | Account No. | |||||
|
(The total of the above two boxes must equal the “Total
Payment Required” specified above.)
|
||||||
|
I (we) on my (our) behalf, or on behalf of any person(s) on
whose behalf, or under whose directions, I am (we are) signing
this form:
|
||
|
• irrevocably elect to exercise the number
of subscription rights indicated above upon the terms and
conditions specified in the Prospectus;
|
||
|
• agree that if I (we) fail to pay for the
Series A Preferred Stock that I (we) have elected to purchase,
you may exercise any remedies available to you under the law; and
|
||
|
• understand that my (our) exercise of
subscription rights may not be withdrawn.
|
||
|
o
|
Please sell of my (our) subscription rights for shares of the Series A Preferred Stock. | |
| (number of rights) | ||
|
o
|
Please do not exercise my (our) subscription rights for shares of the Series A Preferred Stock. | |
Name of beneficial owner(s):
Signature of beneficial owner(s):
If you are signing in your capacity as a trustee, executor,
administrator, guardian, attorney-in-fact, agent, officer of a
corporation or another acting in a fiduciary or representative
capacity, please provide the following information:
Name of each purchaser:
Capacity:
Address (including zip code) of each purchaser:
Telephone Number(s):