FIRST NATIONAL CORP /VA/ - FORM S-1 - EX-99.6 - FORM OF NOMINEE HOLDER CERTIFICATION - May 8, 2012

Attached files

file filename
S-1 - FORM S-1 REGISTRATION STATEMENT - FIRST NATIONAL CORP /VA/fs1fnc.htm
EX-5.1 - OPINION OF WILLIAMS MULLEN - FIRST NATIONAL CORP /VA/ex5-1.htm
EX-4.2 - FORM OF SUBSCRIPTION RIGHTS CERTIFICATE - FIRST NATIONAL CORP /VA/ex4-2.htm
EX-99.2 - FORM OF NOTICE OF GUARANTEED DELIVERY - FIRST NATIONAL CORP /VA/ex99-2.htm
EX-99.5 - FORM OF LETTER TO CLIENTS OF NOMINEE HOLDERS - FIRST NATIONAL CORP /VA/ex99-5.htm
EX-99.7 - FORM OF BENEFICIAL OWNER ELECTION FORM - FIRST NATIONAL CORP /VA/ex99-7.htm
EX-99.8 - FORM OF NOTICE OF IMPORTANT TAX INFORMATION - FIRST NATIONAL CORP /VA/ex99-8.htm
EX-23.1 - CONSENT OF YOUNT, HYDE & BARBOUR, P.C. - FIRST NATIONAL CORP /VA/ex23-1.htm
EX-99.9 - SUBSCRIPTION AGENT AGREEMENT, DATED MAY 1, 2012, BY AND BETWEEN THE COMPANY AND REGISTRAR AND TRANSFER COMPANY - FIRST NATIONAL CORP /VA/ex99-9.htm
EX-99.4 - FORM OF LETTER TO NOMINEE HOLDERS WHOSE CLIENTS ARE BENEFICIAL HOLDERS - FIRST NATIONAL CORP /VA/ex99-4.htm
EX-99.1 - FORM OF INSTRUCTION FOR USE OF SUBSCRIPTION RIGHTS CERFICIATES - FIRST NATIONAL CORP /VA/ex99-1.htm
EX-99.10 - FORM OF STANDBY PURCHASE AGREEMENT - FIRST NATIONAL CORP /VA/ex99-10.htm
EX-99.3 - FORM OF LETTER TO SHAREHOLDERS WHO ARE RECORD HOLDERS - FIRST NATIONAL CORP /VA/ex99-3.htm
Exhibit 99.6
 
FIRST NATIONAL CORPORATION
NOMINEE HOLDER CERTIFICATION
 
The undersigned, a broker, custodian bank, trustee, depositary or other nominee holder of rights (the “Rights”) to purchase shares of First National Corporation (the “Company”) pursuant to the rights offering described and provided for in the Company’s registration statement, as amended, and final prospectus dated __________, 2012 (the “Prospectus”), hereby certifies to the Company and Registrar and Transfer Company, as subscription agent for the Rights Offering, that (1) the undersigned has exercised, on behalf of the beneficial owners thereof (which may include the undersigned), the number of Rights specified below pursuant to the basic subscription right (as defined in the Prospectus), and on behalf of beneficial owners of Rights who have subscribed for the purchase of additional shares pursuant to the over-subscription privilege (as defined in the Prospectus), listing separately below each such exercised basic subscription right and the corresponding over-subscription privilege (without identifying any such beneficial owner), and (2) each such beneficial owner’s basic subscription right has been exercised in full:
 
         
Number of Shares of
Common Stock Owned on the
Record Date
  
Rights Exercised Pursuant to
Basic Subscription Rights
  
Number of Shares Subscribed
For Pursuant to Over-
Subscription Privilege
     
1.
        
2.
        
3.
        
4.
        
5.
        
6.
        
7.
        
8.
        
9.
        
10.
        
 
Provide the following information if applicable:
 
Depository Trust Company (“DTC”) Participant Number
 
 
 
     
   
Participant Name:
    
 
     
   
By:
    
 
     
   
Name:
    
 
     
   
Title:
    
 
DTC Basic Subscription Confirmation Number(s)

FIRST NATIONAL CORP /VA/ Reports