EX-99.(D) 3 ex99-d.htm FORM OF NON-TRANSFERABLE SUBSCRIPTION RIGHTS CERTIFICATE
 

High Income Securities Fund N-2/A

Exhibit 99.(d)

 

RIGHTS CERTIFICATE #:NUMBER OF RIGHTS

THE TERMS AND CONDITIONS OF THE RIGHTS OFFERING ARE SET FORTH IN THE COMPANY’S PROSPECTUS 

DATED [●], 2024 (THE “PROSPECTUS”) AND ARE INCORPORATED HEREIN BY REFERENCE. COPIES OF

THE PROSPECTUS ARE AVAILABLE UPON REQUEST FROM InvestorCom, THE INFORMATION AGENT.

 

High Income Securities Fund

Incorporated under the laws of the State of Massachusetts

 

NON - TRANSFERABLE SUBSCRIPTION RIGHTS CERTIFICATE

 

Evidencing Non - Transferable Subscription Rights to Purchase Shares of Beneficial Interest of High Income Securities Fund

 

Estimated Subscription Price:  $[●] per Share

 

THE SUBSCRIPTION RIGHTS WILL EXPIRE IF NOT EXERCISED ON OR BEFORE 5:00 P.M., NEW YORK CITY TIME,
ON [●], 2024, UNLESS EXTENDED BY THE COMPANY

 

REGISTERED

OWNER:

 

THIS CERTIFIES THAT the registered owner whose name is inscribed hereon is the owner of the number of non-transferable subscription rights (“Rights”) set forth above. Each Right entitles the holder thereof to subscribe for and purchase one share of beneficial interest of High Income Securities Fund, a Massachusetts business trust, at an estimated subscription price (the “Estimated Subscription Price”) of $[●] per share (the “Basic Subscription Privilege”), pursuant to a rights offering (the “Rights Offering”), on the terms and subject to the conditions set forth in the Prospectus and the “Instructions as to Use of High Income Securities Fund Subscription Rights Certificates” accompanying this Subscription Rights Certificate. If any shares of beneficial interest available for purchase in the Rights Offering are not purchased by other holders of Rights pursuant to the exercise of their Basic Subscription Privilege (the “Excess Shares”), any Rights holder that

 

exercises its Basic Subscription Privilege in full may subscribe for a number of Excess Shares pursuant to the terms and conditions of the Rights Offering, as described in the Prospectus (the “Additional Subscription Privilege”). In addition, the Fund may issue additional shares up to 10% of the shares available in the Rights Offering to honor Additional Subscription Privilege requests. The Rights represented by this Subscription Rights Certificate may be exercised by completing Form 1 and any other appropriate forms on the reverse side hereof and by retuning the full payment of the subscription price for each share of beneficial interest. For Instructions on the use of High Income Securities Fund Subscription Rights Certificates, consult with InvestorCom, the Information Agent, at (877) 972-0090.

 

This Subscription Rights Certificate is not valid unless countersigned by the subscription agent and registered by the registrar.

 

Witness the seal of High Income Securities Fund and the signatures of its duly authorized officers.

 

Dated: [●], 2024

 

/s/ Andrew Dakos  /s/ Phillip Goldstein  
 President  Secretary  

 

 

 

DELIVERY OPTIONS FOR SUBSCRIPTION RIGHTS CERTIFICATE

 

Delivery other than in the manner or to the addresses listed below will not constitute valid delivery.

 

If delivering by first class mail:

Broadridge, Inc.

Attn: BCIS Re-Organization Dept.

P.O. Box 1317

Brentwood, NY 11717-0718

 

If delivering by overnight courier:

Broadridge, Inc.

Attn: BCIS IWS

51 Mercedes Way

Edgewood, NY 11717 

 

 

PLEASE PRINT ALL INFORMATION CLEARLY AND LEGIBLY.

 

FORM 1-EXERCISE OF SUBSCRIPTION RIGHTS

 

To subscribe for shares pursuant to your Basic Subscription Right, please complete lines (a) and (c) and sign under Form 3 below. To subscribe for shares pursuant to your Additional Subscription Right, please also complete line (b) and sign under Form 3 below. To the extent you subscribe for more Shares than you are entitled under either the Basic Subscription Right or the Additional Subscription Right, you will be deemed to have elected to purchase the maximum number of shares for which you are entitled to subscribe under the Basic Subscription Right or Additional Subscription Right, as applicable.

 

(a) EXERCISE OF BASIC SUBSCRIPTION RIGHT:

 

 I apply for ________ shares x   $[●] = $_______________
       (no. of new shares)   (estimated 
subscription price)
(amount enclosed)

  

(b) EXERCISE OF ADDITIONAL SUBSCRIPTION RIGHT

 

If you have exercised your Basic Subscription Right in full and wish to subscribe for additional shares of beneficial interest pursuant to your Additional Subscription Right:

 

 I apply for ________ shares x   $[●] = $_______________
       (no. of new shares) (estimated)
subscription price)
(amount enclosed)

 

(c) Total Amount of Payment Enclosed = $__________________

 

METHOD OF PAYMENT (CHECK ONE)

 

Check or bank draft payable to “Broadridge Corporate Issuer Solutions, LLC”

 

Wire transfer of immediately available funds directly to the following account:

Routing number: 123000848

International/Swift code: USBKUS44IMT

Bank: U.S. Bank

800 Nicollet Mall

Minneapolis, MN 55402 United States

Beneficiary Account Name: Broadridge

Account Number: 153910728465

For Further Credit Name: High Income Securities Fund

For Further Credit Account: 153912017271

 

IMPORTANT: In the event that the Estimated Subscription Price is more than the Subscription Price on the Expiration Date, any resulting excess amount paid by you towards the purchase of Shares in this Rights Offering will be applied by the Fund towards the purchase of additional Shares under the Basic Subscription Privilege or, if you have exercised all of the Rights initially issued to you under the Basic Subscription Privilege, towards the purchase of an additional number of Shares pursuant to the Additional Subscription Privilege. If you desire that such excess not be treated by the Fund as a request to acquire additional Shares in the Rights Offering, and that such excess be refunded to you, you must place an “X” in the box at the end of this sentence: [   ]

FORM 2-DELIVERY TO DIFFERENT ADDRESS

 

If you wish for the beneficial interest underlying your subscription rights, a certificate representing unexercised subscription rights or the proceeds of any sale of subscription rights to be delivered to an address different from that shown on the face of this Subscription Rights Certificate, please enter the alternate address below, sign under Form 3 and have your signature guaranteed under Form 4.

 

 

 

 

 

 

 

FORM 3-SIGNATURE

 

TO SUBSCRIBE: I acknowledge that I have received the Prospectus for this Rights Offering and I hereby irrevocably subscribe for the number of shares indicated above on the terms and conditions specified in the Prospectus.

 

Signature(s):

 

IMPORTANT: The signature(s) must correspond with the name(s) as printed on the reverse of this Subscription Rights Certificate in every particular, without alteration or enlargement, or any other change whatsoever.

 

FORM 4-SIGNATURE GUARANTEE

 

This form must be completed if you have completed any portion of Forms 2.

 

Signature Guaranteed:
 (Name of Bank or Firm)

  

By:
          (Signature of Officer)

 

IMPORTANT: The signature(s) should be guaranteed by an eligible guarantor institution (bank, stock broker, savings & loan association or credit union) with membership in an approved signature guarantee medallion program pursuant to Securities and Exchange Commission Rule 17Ad-15.


FOR INSTRUCTIONS ON THE USE OF HIGH INCOME SECURITIES FUND SUBSCRIPTION RIGHTS CERTIFICATES, CONSULT INVESTORCOM, THE INFORMATION AGENT, AT (877) 972-0090.