EX-99.A.4 6 exa-4.txt EXHIBIT 99(A)(4) [FORM OF CONFIRMATION CARD] ride the light [GRAPHIC OMITTED] Confirmation of Receipt of Election Form and Release Agreement Qwest To: __________________________________ This is not confirmation that your election form has been completed correctly. This card is confirmation that your Election Form and Release Agreement for the Qwest Communications International Inc. Offer to Exchange Certain Outstanding Qwest Stock Options has been received by: _____________________________________ on: ______________ Qwest Stock Administration Department Date Received Qwest Communications International Inc. Stock Administration Department 555 17th Street, 10th Floor Denver, CO 80202 Employee Name Address line 1 Address Line2 City, ST Zip