FORM OF NOTICE OF CONVERSION
EX-10.17 6 d564500dex1017.htm EX-10.17 EX-10.17
Exhibit 10.17
FORM OF
NOTICE OF CONVERSION
In consideration of $10.00 paid to the holder hereof, along with a waiver of all dividend rights relating to the Dividend Period subsequent to March 30, 2013, for all shares of 15% Series A1 Convertible Preferred Stock (Series A1 Preferred Stock) of Arête Industries, Inc., (the Company) in the name of the undersigned, the undersigned holder does hereby elect to convert shares of 15% Series A1 Preferred Stock into shares of common stock of the Company (at a deemed conversion price of $0.75 per common share) and does hereby tender to the Company a stock certificate in respect of such converted shares.
HOLDER | ||
By: |
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Name: |
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Date: June 28, 2013 |
ACCEPTED: | ||
ARÊTE INDUSTRIES, INC. | ||
By: |
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Nicholas Scheidt | ||
President and Chief Executive Officer | ||
Date: June 28, 2013 |