EX-99.6 9 a2046745zex-99_6.txt NOTICE OF GUARANTEED DELIVERY NOTICE OF GUARANTEED DELIVERY FOR RIGHTS CERTIFICATES ISSUED BY PENN TREATY AMERICAN CORPORATION This form, or one substantially equivalent hereto, must be used to exercise Rights pursuant to the Rights Offering described in the Prospectus Supplement dated April 25, 2001, to the Prospectus dated November 15, 2000 (the "Prospectus Supplement") of Penn Treaty American Corporation, a Pennsylvania corporation (the "Company"), if a holder of rights cannot deliver the Rights Certificate(s) evidencing the Rights (the "Rights Certificate(s)"), to the Subscription Agent listed below (the "Subscription Agent") at or prior to 5:00 p.m., Eastern Time, on May 25, 2001, unless extended by the Company (as it may be extended, the "Expiration Date"). Such form must be delivered by hand or sent by facsimile transmission, overnight courier or mail to the Subscription Agent, and must be received by the Subscription Agent at or prior to the Expiration Date. See "Description of Rights--Exercise of Rights" in the Prospectus Supplement. Payment of the Subscription Price of $2.40 per share subscribed for pursuant to the Basic Subscription Privilege and the Oversubscription Privilege must be received by the Subscription Agent in the manner specified in the Instructions as to Use of Rights Certificates at or prior to the Expiration Date even if the Rights Certificate evidencing such Rights is being delivered pursuant to the procedure for guaranteed delivery thereof. THE SUBSCRIPTION AGENT IS: FIRST UNION NATIONAL BANK GENERAL INFORMATION: ------------------------------------------------------------------------------------------- Facsimile Transmission By Hand or By Mail: Copy Number: Overnight Courier: ------------------------------------------------------------------------------------------- First Union National Bank (704) 590-7628 First Union National Bank 1525 West W.T. Harris Confirm Facsimile by 1525 West W.T. Harris Boulevard, 3C3 Telephone: Boulevard, 3C3 Charlotte, NC 28262-1153 (704) 590-7411 Charlotte, NC 28262-1153 Attention: Corporate Actions, Attention: Corporate Actions, Corporate Trust Operations Corporate Trust Operations -------------------------------------------------------------------------------------------
DELIVERY OF THIS INSTRUMENT TO AN ADDRESS OTHER THAN AS SET FORTH ABOVE OR TRANSMISSION OF INSTRUCTIONS VIA A FACSIMILE OTHER THAN THAT SET FORTH ABOVE DOES NOT CONSTITUTE A VALID DELIVERY. Ladies and Gentlemen: The undersigned hereby represents that he or she is the holder of Rights Certificate(s) representing Rights and that such Rights Certificate(s) cannot be delivered to the Subscription Agent. Upon the terms and subject to the conditions set forth in the Prospectus Supplement, receipt of which is hereby acknowledged, the undersigned hereby elects to exercise (i) the Basic Subscription Privilege to subscribe for one share of Common Stock per Right with respect to Rights represented by such Rights Certificate and (ii) the Oversubscription Privilege, to the extent that Remaining Shares (as defined in the Prospectus Supplement) are available therefor, for an aggregate of up to Remaining Shares. The undersigned understands that payment of the Subscription Price of $2.40 per share subscribed for pursuant to the Basic Subscription Privilege and the Oversubscription Privilege must be received by the Subscription Agent within three New York Stock Exchange trading days following the Expiration Date, and represents that such payment, in the aggregate amount of $ , either (check appropriate box(es)): / / is being delivered to the Subscription Agent; or / / has been delivered separately to the Subscription Agent; and is being or was delivered in the manner set forth below (check appropriate box and complete information relating thereto): / / Wire Transfer of Funds directed to First Union National Bank, ABA Routing No. 0530-00219, Account No. 5000000016439; Reference Penn Treaty American Corporation. Name of transferor institution __________________________________________ Date of transfer ________________________________________________________ Confirmation number (if available) ______________________________________ / / Uncertified check payable to First Union National Bank, as Subscription Agent (Payment by uncertified check will not be deemed to have been received by the Subscription Agent until such check has cleared. Rights holders paying by such means are urged to make payment sufficiently in advance of the Expiration Date to ensure that such payment clears by such date.) Name of maker ___________________________________________________________ Date of check ___________________________________________________________ Bank on which check is drawn ____________________________________________ / / Certified check payable to First Union National Bank Name of maker ___________________________________________________________ Date of check ___________________________________________________________ Bank on which check is drawn ____________________________________________ / / Cashier's check payable to First Union National Bank Name of maker ___________________________________________________________ Date of draft ___________________________________________________________ / / Money order payable to First Union National Bank Issuer of money order ___________________________________________________ Date of money order _____________________________________________________ Signature(s) ------------------------------- Address ------------------------------------ ------------------------------------------ ----------------------------------------- Name(s) --------------------------------- ----------------------------------------- Please type or print (Include Zip Code) ------------------------------------------ Telephone Numbers -------------------------- ------------------------------------------ ------------------------------------------ (If signature is by a trustee(s), executors(s), administrator(s), guardian(s), Rights Certificates No(s.) attorney(s)-in-fact, agent(s), officer(s) or (if available) ---------------------------- a corporation or another acting in a fiduciary or representative capacity, such capacity must be clearly indicated above).
GUARANTEE OF DELIVERY (Not to be used for Rights Certificate Signature Guarantee) The undersigned, a member firm of a registered national securities exchange or of the National Association of Securities Dealers, Inc. or a commercial bank or trust company having an office or correspondent in the United States, guarantees that the undersigned will deliver to the Subscription Agent the Rights Certificate(s) representing the Rights being exercised hereby, with any required signature guarantees and any other required documents and the Subscription Price, all within three New York Stock Exchange trading days following the Expiration Date. ---------------------------------- Dated: --------------------------, 2001 (Name of Firm) Address: ------------------------------ ---------------------------------- (Authorized Signature) ---------------------------------- -------------------------------------- (Name) (Including Zip Code) ---------------------------------- -------------------------------------- (Title) (Area Code and Telephone Number)
The institution which completes this form must communicate the guarantee to the Subscription Agent and must deliver the Rights Certificate(s) and the Subscription Price to the Subscription Agent within the time period shown therein. Failure to do so could result in a financial loss to such institution.