EX-99.7 12 g02257a1exv99w7.htm EX-99.7 BENEFICIAL OWNER ELECTION FORM EX-99.7 BENEFICIAL OWNER ELECTION FORM
 

Exhibit 99.7
 
BENEFICIAL OWNER ELECTION FORM
 
I (we) acknowledge receipt of your letter and the enclosed materials relating to the grant of non-transferable rights to purchase shares of common stock, par value $0.01 per share, of Exide Technologies (the “Company”).
 
I (we) hereby instruct you as follows:
 
(CHECK THE APPLICABLE BOXES AND PROVIDE ALL REQUIRED INFORMATION)
 
     
o
  Please exercise my (our) rights for shares of common stock as set forth below:
     
A.
 
Number of Shares Being Purchased: _ _
B.
  Total Exercise Price Payment Required (or amount provided with Notice Guaranteed Delivery):
 
                 
  x   $3.50   =   _ _
(No. of Shares)
       (Exercise Price)         (Payment)
 
I am (we are) making the total purchase price payment required in the following manner:
 
     
o
  Payment in the following amount is enclosed: $ _ _; or
     
     
o
  Please deduct payment of $ _ _ from the following account maintained by you as follows:
     
(The total of the above two boxes must equal the total purchase price specified on line “B” 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.
 
o  Please sell _ _ of my (our) rights.
               (number of rights)
 
o   Please do not exercise my (our) rights for shares of common stock.
 


 

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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