Attached files

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S-1 - TURBOSONIC TECHNOLOGIES, INC. - TURBOSONIC TECHNOLOGIES INCforms-1_16922.htm
EX-4.2 - CERTIFICATE FOR RIGHTS - TURBOSONIC TECHNOLOGIES INCexh4-2_16922.htm
EX-99.5 - FORM OF LETTER TO CLIENTS - TURBOSONIC TECHNOLOGIES INCexh99-5_16922.htm
EX-99.4 - FORM OF LETTER TO STOCKHOLDERS - TURBOSONIC TECHNOLOGIES INCexh99-4_16922.htm
EX-99.1 - FORM OF INSTRUCTIONS - TURBOSONIC TECHNOLOGIES INCexh99-1_16922.htm
EX-23.1 - CONSENT OF DELOITTE & TOUCHE LLP - TURBOSONIC TECHNOLOGIES INCexh23-1_16922.htm
EX-99.2 - FORM OF NOTICE OF GUARANTEED DELIVERY - TURBOSONIC TECHNOLOGIES INCexh99-2_16922.htm
EX-99.7 - NOMINEE HOLDER CERTIFICATION - TURBOSONIC TECHNOLOGIES INCexh99-7_16922.htm
EX-99.3 - FORM OF LETTER TO SECURITY DEALERS - TURBOSONIC TECHNOLOGIES INCexh99-3_16922.htm

Exhibit 99.6
 
BENEFICIAL OWNER ELECTION FORM
 
The undersigned acknowledge(s) receipt of your letter and the enclosed materials relating to the grant of non-transferable rights (the “Rights”) to purchase shares of common stock, par value $0.01 per share (the “Common Stock”), of Turbosonic Technologies, Inc. (the “Company”).
 
This will instruct you whether to exercise Rights to purchase shares of Common Stock distributed with respect to the shares of 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 related “Instructions as to Use of Turbosonic Technologies, Inc. Rights Certificates.”
 
I (we) hereby instruct you as follows:
 
(CHECK THE APPLICABLE BOXES AND PROVIDE ALL REQUIRED INFORMATION)
 
Box 1.
o
Please DO NOT EXERCISE RIGHTS for shares of Common Stock.
 
Box 2.
o
Please EXERCISE RIGHTS for shares of Common Stock as set forth below:
 
   
Number of Shares of
Common Stock
Subscribed For
   
Subscription
Price
   
Payment
Basic Subscription Privilege
 
 
x  
$[•]
=
$
 
 (Line 1)
Over-Subscription Privilege
 
 
x  
$[•]
=
$
 
 (Line 1)
Total Payment Required
           
$
 
 (Sum of Lines 1 and 2)
                 
Box 3.
o
Payment in the following amount is enclosed: $_______
 
Box 4.
o
Please deduct payment of $_______ from the following account maintained by you as follows:
 
(The total of Box 3 and Box 4 must equal the total payment specified above.)
 
Type of Account ____________________ Account No. ____________________
 
I (we) on my (our) own 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 purchase the number of shares of common stock indicated above upon the terms and conditions specified in the prospectus; and
 
·  
agree that if I (we) fail to pay for the shares of common stock I (we) have elected to purchase, you may exercise any remedies available to you under law.
 
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:

 
Capacity:

 
Address (including Zip Code):

 
Telephone Number:

 
 

 
 
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