EX-99.8 12 dex998.htm BENEFICIAL OWNER ELECTION FORM BENEFICIAL OWNER ELECTION FORM

 

EXHIBIT 99.8

 

BENEFICIAL OWNER ELECTION FORM

 

INSTRUCTIONS

 

The undersigned acknowledge(s) receipt of your letter and the enclosed materials referred to therein relating to the offering of shares of common stock (the “Common Stock”) of V.I. Technologies, Inc. (“Vitex”).

 

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 For Use of V.I. Technologies, Inc. Rights Certificates.”

 

Box 1. ¨        Please DO NOT EXERCISE RIGHTS for shares of Common Stock.

 

Box 2. ¨        Please EXERCISE RIGHTS for shares of Common Stock as set forth below.

 

    

Number of

Rights

          

Subscription

Price

        

Payment

     

Basic Subscription Privilege:

        

x

     

$

1.02

   

=

   

$          

   

(Line 1)

Oversubscription Privilege:

        

x

     

$

1.02

   

=

   

$      

   

(Line 2)

                            
    

Total Payment Required

                      

=

   

$      

   

(Sum of Lines 1 and 2; must equal total of amounts in Boxes 3 and 4)

 

Box 3. ¨        Payment in the following amount is enclosed $            .

 

Box 4. ¨        Please deduct payment from the following account maintained by you as follows:

 

  

Type of Account

  

Account No.

 

Amount to be deducted:

$                        

 

Box 5. ¨        Please transfer my Rights and issue a new Rights certificate evidencing such transferred Rights pursuant to and in accordance with my instructions set forth below. Unless other instructions are provided herewith, the Rights certificate for the Rights transferred should be delivered to the address provided below.

 

Number of Rights to be transferred:                                         

Name of transferree:                                         

Address for delivery of certificate for transferred rights:                                                              

 

 

 

 

 

Signature(s)

(Joint owners should each sign personally. Where applicable, please indicate your official position or representative capacity.)

 

Please type or print name(s) below:

 

 

Date:                         , 2003