Date: July 3, 2012
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POINTER TELOCATION LTD.
By: /s/ Yossi Ben Shalom
——————————————
Yossi Ben Shalom
Chairman of the Board of Directors
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Hand delivery express mail, courier, or other
expedited service:
American Stock Transfer & Trust Company, LLC
Operations Center
Attn: Reorganization Department
6201 15th Avenue
Brooklyn, New York 11219
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Mail:
American Stock Transfer & Trust Company, LLC
Operations Center
Attn: Reorganization Department
P.O. Box 2042
New York, New York 10272-2042
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Pointer Telocation Ltd.
Attn: Zvi Fried, Chief Financial Officer
14 Hamelacha Street
Afek Industrial Park, Rosh Haayin 48091, Israel
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SUBSTITUTE
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Part 1 - PLEASE PROVIDE
YOUR TIN IN
THE BOX AT RIGHT AND
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TIN:
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Form W-9
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CERTIFY BY SIGNING AND
DATING BELOW
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Social Security Number or
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Department of the Treasury
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Employer Identification Number
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Internal Revenue Service
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Payer's Request for Taxpayer
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Part 2 - TIN Applied for o
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Identification Number (“TIN”)
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(1)
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the number shown on this form is my correct Taxpayer Identification Number (or I am waiting for a number to be issued to me);
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(2)
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I am not subject to backup withholding either because (a) I am exempt from backup withholding or (b) I have not been notified by the Internal Revenue Service (the “IRS”) that I am subject to backup withholding as a result of a failure to report all interest or dividends or (c) the IRS has notified me that I am no longer subject to backup withholding; and
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(3)
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I am a U.S. person (including a U.S. resident alien).
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SIGNATURE
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DATE
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NOTE:
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FAILURE TO COMPLETE AND RETURN THIS FORM MAY RESULT IN BACKUP WITHHOLDING ON ANY PAYMENTS MADE TO YOU IN CONNECTION WITH THE RIGHTS OFFERING. PLEASE REVIEW THE ENCLOSED GUIDELINES FOR CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER ON SUBSTITUTE FORM W-9 FOR ADDITIONAL DETAILS.
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SIGNATURE
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DATE
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For this type of account
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Give the SOCIAL SECURITY
number of
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For this type of account
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Give the EMPLOYER
IDENTIFICATION number of
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1. Individual
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The individual
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6. Sole proprietorship
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The owner 3
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2 Two or more individuals (joint account)
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The actual owner of the account, or if combined funds, the first individual on the account1
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7 A valid trust, estate, or pension trust
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The legal entity 4
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3. Custodian account of a minor (Uniform Gift to Minors Act)
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The minor 2
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8. Corporate
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The corporation
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4. a. The usual revocable savings trust
account (grantor is also trustee)
b. So-called trust account that is not a
legal or valid trust under state law
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The grantor-trustee 1
The actual owner 1
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9. Association, club, religious,
charitable, educational,
or other tax-exempt organization
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The organization
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5. Sole proprietorship
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The owner 3
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10. Partnership
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The partnership
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11. A broker or registered nominee
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The broker or nominee
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12. Account with the
Department of Agriculture
in the name of a public entity
(such as a state or local government,
school district, or prison)
that receives agricultural
program payments
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The public entity
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(1)
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List first and circle the name of the person whose number you furnish. If only one person on a joint account has a social security number, that person's number must be furnished.
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(2)
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Circle the minor's name and furnish the minor's social security number.
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(3)
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You must show your individual name, but you may also enter your business or "doing business as" name. You may use either your social security number or your employer identification number (if you have one).
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(4)
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List first and circle the name of the legal trust, estate, or pension trust. (Do not furnish the taxpayer identification number of the personal representative or trustee unless the legal entity itself is not designated in the account title.)
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·
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An organization exempt from tax under Section 501(a), an individual retirement account (IRA), or a custodial account under Section 403(b)(7), if the account satisfies the requirements of Section 401(f)(2).
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·
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The United States or a state thereof, the District of Columbia, a possession of the United States, or a political subdivision or wholly-owned agency or instrumentality of any one or more of the foregoing.
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·
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An international organization or any agency or instrumentality thereof.
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·
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A corporation.
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·
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A financial institution.
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·
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A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States.
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·
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A real estate investment trust.
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·
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A common trust fund operated by a bank under Section 584(a).
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·
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An entity registered at all times during the tax year under the Investment Company Act of 1940.
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·
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A middleman known in the investment community as a nominee or who is listed in the most recent publication of the American Society of Corporate Secretaries, Inc., Nominee List.
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·
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A futures commission merchant registered with the Commodity Futures Trading Commission.
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·
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A foreign central bank of issue.
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·
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Payments to nonresident aliens subject to withholding under Section 1441.
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·
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Payments to partnerships not engaged in a trade or business in the United States and that have at least one nonresident alien partner.
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·
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Payments of patronage dividends not paid in money.
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·
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Payments made by certain foreign organizations.
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·
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Section 404(k) payments made by an ESOP.
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·
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Payments of interest on obligations issued by individuals. Note: You may be subject to backup withholding if this interest is $600 or more and you have not provided your correct taxpayer identification number to the payer.
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·
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Payments of tax-exempt interest (including exempt- interest dividends under Section 852).
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·
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Payments described in Section 6049(b)(5) to nonresident aliens.
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·
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Payments on tax-free covenant bonds under Section 1451.
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·
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Payments made by certain foreign organizations.
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·
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Mortgage interest paid to you.
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(1)
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Failure to Furnish TaxpayerIdentification Number - If you fail to furnish your taxpayer identification number to a payer, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.
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(2)
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Civil Penalty for False Information With Respect to Withholding - If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.
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(3)
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Criminal Penalty for Falsifying Information - Willfully falsifying certificates or affirmations may subject you to criminal penalties including fines and/or imprisonment.
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·
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You will receive one non-transferable subscription right for every 7.626 ordinary shares you hold of record at the close of business on June 29, 2012. We will not issue fractional subscription rights or cash in lieu of fractional subscription rights. Fractional subscription rights will be rounded down to the nearest whole number.
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·
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You may purchase one ordinary share, par value NIS 3.00 of Pointer Telocation Ltd. for each whole subscription right you receive at a subscription price of $2.90 per share.
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·
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If you exercise in full the subscription rights issued to you, you may subscribe for additional ordinary shares through the over-subscription right, as more fully described in the prospectus supplement.
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·
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The Rights Offering will expire at 5:00 p.m., Eastern Time (midnight, Israel time), on July 26, 2012. If you do not exercise your subscription rights before that time, they will expire and will have no monetary value.
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·
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You cannot revoke the exercise of either your basic or over-subscription rights.
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·
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If your ordinary shares are held in the name of a bank, dealer or other nominee, you must contact your bank, dealer or other nominee if you wish to participate in the Rights Offering.
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Very truly yours,
POINTER TELOCATION LTD.
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1.
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Prospectus Supplement;
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2.
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Form of Notice to Clients of Shareholders who are Acting as Nominees;
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3.
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Form of Beneficial Owner Election Form; and
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4.
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Form of Nominee Holder Certification.
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Very truly yours,
POINTER TELOCATION LTD.
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·
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You will receive one non-transferable subscription right for every 7.626 ordinary shares you hold of record at the close of business on June 29, 2012. Pointer will not issue fractional subscription rights or cash in lieu of fractional subscription rights. Fractional subscription rights will be rounded down to the nearest whole number.
|
·
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You may purchase one ordinary share, par value NIS 3.00 of Pointer for each whole subscription right you receive at a subscription price of $2.90 per share.
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·
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If you exercise in full the subscription rights issued to you, you may subscribe for additional ordinary shares through the over-subscription right, as more fully described in the prospectus supplement.
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·
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The Rights Offering will expire at 5:00 p.m., Eastern Time, on July 26, 2012 (the “Expiration Date”). If you do not exercise your subscription rights before that time, they will expire and will have no monetary value.
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·
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You cannot revoke your exercise of your subscription rights at any time prior to the expiration of the Rights Offering.
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Very truly yours,
[ ]
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Number of Ordinary Shares
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Per Share Subscription Price
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Payment
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Basic Subscription Right:
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x | $ | 2.90 | = | $ | |||||
Over-Subscription Right:
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x | $ | 2.90 | = | $ | |||||
Total Payment Required:
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$ |
Type of Account
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Account No.
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Amount to be deducted:
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$
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Date:
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Signature(s)
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Please type or print
name(s) below
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Number of Shares Owned on the
Record Date
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Number of Shares Subscribed for
Pursuant to Basic Subscription Right
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Number of Shares Subscribed for
Pursuant to Over-Subscription Right
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1.
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||||||
2.
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3.
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4.
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5.
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6.
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7.
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8.
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||||||
9.
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||||||
Name of Nominee Holder
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DTC Participant Number
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|||||
By:
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||||||
Name:
Title:
Phone Number:
Fax Number:
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DTC Basic Subscription
Confirmation Numbers
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RIGHTS CERTIFICATE #: | NUMBER OF RIGHTS | |||
THE TERMS AND CONDITIONS OF THE RIGHTS OFFERING ARE SET FORTH IN THE COMPANY'S PROSPECTUS
SUPPLEMENT DATED JUNE 19, 2012 (THE "PROSPECTUS") AND ARE INCORPORATED HEREIN BY REFERENCE. COPIES OF
THE PROSPECTUS ARE AVAILABLE UPON REQUEST FROM THE COMPANY.
Pointer Telocation Ltd.
Incorporated under the laws of the State of Israel
NON - TRANSFERABLE SUBSCRIPTION RIGHTS CERTIFICATE
Evidencing Non - Transferable Subscription Rights to Purchase Ordinary Shares of Pointer Telocation Ltd.
Subscription Price: $2.90 per Share
THE SUBSCRIPTION RIGHTS WILL EXPIRE IF NOT EXERCISED ON OR BEFORE 5:00 P.M., NEW YORK CITY TIME,
ON July 26, 2012
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REGISTERED
OWNER:
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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 whole Right entitles the holder thereof to subscribe for and purchase one ordinary share, with a par value of NIS 3.00 per share, of Pointer Telocation Ltd., an Israeli company, at a subscription price of $2.90 per share (the “Basic Subscription Right”), 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 Pointer Telocation Ltd. Subscription Rights Certificates” accompanying this Subscription Rights Certificate. If any ordinary shares available for purchase in the Rights Offering are not purchased by other holders of Rights pursuant to the exercise of their Basic Subscription Right
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(the “Excess Shares”), any Rights holder that exercises its Basic Subscription Right in full may subscribe for a number of Excess Shares pursuant to the terms and conditions of the Rights Offering, subject to proration, as described in the Prospectus (the “Over-Subscription Right”). 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 ordinary share in accordance with the “Instructions as to Use of Pointer Telocation Ltd. Subscription Rights Certificates” that accompany this Subscription Rights Certificate.
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![]() |
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This Subscription Rights Certificate is not valid unless countersigned by the subscription agent and registered by the registrar. Witness the seal of Pointer Telocation Ltd. and the signatures of its duly authorized officers.
Dated: June 29, 2012
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_________________________________
David Mahlab
President and Chief Executive Officer
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_________________________________
Zvi Fried
Chief Financial Officer
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If delivering by hand, express mail, courier, or other
expedited service:
American Stock Transfer & Trust Company, LLC
Operations Center
Attn: Reorganization Department
6201 15th Avenue
Brooklyn, New York 11219
|
If delivering by mail:
American Stock Transfer & Trust Company, LLC
Operations Center
Attn: Reorganization Department
P.O. Box 2042
New York, New York 10272-2042
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If you reside in Israel, you may deliver your Subscription
Rights Certificate to:
Pointer Telocation Ltd.
Attn: Zvi Fried, CFO
14 Hamelacha Street
Afek Industrial Park, Rosh Haayin 48091, Israel
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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 Over-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 Over-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 Over-Subscription Right, as applicable.
(a) EXERCISE OF BASIC SUBSCRIPTION RIGHT:
I apply for ______________ shares x $ 2.90 = $_______________
(no. of new shares) (subscription price) (amount enclosed)
(b) EXERCISE OF OVER-SUBSCRIPTION RIGHT
If you have exercised your Basic Subscription Right in full and wish to subscribe for additional ordinary shares pursuant to your Over-Subscription Right:
I apply for ______________ shares x $ 2.90 = $_______________
(no. of new shares) (subscription price) (amount enclosed)
(c) Total Amount of Payment Enclosed = $__________________
METHOD OF PAYMENT (CHECK ONE)
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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 Form 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.
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¨
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Bank check payable to “American Stock Transfer & Trust Company,
LLC, as Subscription Agent.”
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¨
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Wire transfer of immediately available funds directly to the account
maintained by American Stock Transfer & Trust Company, LLC, for this rights offering at JPMorgan Chase, ABA # 021000021, A/C # 530-354624; Beneficiary: American Stock Transfer; Reference: “AST as Depository Agent for Pointer Telocation Ltd.”; JP Morgan Chase swift code: CHASUS33, with reference to the rights holder's name.
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||
¨
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For Israeli Residents (Optional):
Payment of U.S. dollars by wire transfer of immediately available funds directly to Bank Hapoalim, 50 Rothschild, Tel Aviv, Branch # 600, Account # 543203, IBAN: IL59-0126-0000-0000-0543-203, Swift Code POALILIT, Reference : “Rights Offering”, with reference to the rights holder's name
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FORM 2-DELIVERY TO DIFFERENT ADDRESS
If you wish for the ordinary shares underlying your subscription rights or a
certificate representing unexercised 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.
____________________________________________________________
____________________________________________________________
____________________________________________________________
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