VICON INDUSTRIES, INC. UP TO 9,348,388SHARES OF COMMON STOCK ISSUABLE UPON EXERCISE OF NON-TRANSFERABLE RIGHTS TO SUBSCRIBE FOR SUCH SHARES NOMINEE HOLDER CERTIFICATION

Contract Categories: Business Finance - Stock Agreements
EX-4.7 9 exhibit47-formofnomineehol.htm EXHIBIT 4.7 Exhibit


EXHIBIT 4.7

VICON INDUSTRIES, INC.
 
UP TO 9,348,388 SHARES OF COMMON STOCK
ISSUABLE UPON EXERCISE OF NON-TRANSFERABLE RIGHTS
TO SUBSCRIBE FOR SUCH SHARES
 
NOMINEE HOLDER CERTIFICATION

The undersigned, a bank, custodian bank or other nominee holder (the “Nominee Holder”) of rights (the “Subscription Rights”) to purchase shares of common stock, par value $0.01 per share (the “Shares”) of VICON INDUSTRIES, INC. (the “Company”), pursuant to the rights offering described in the Company’s Prospectus, dated [•], 2017, hereby certifies to the Company and Broadridge Corporate Issuer Solutions, Inc., as subscription agent for the rights offering, that the undersigned has exercised, on behalf of the beneficial owners thereof (which may include the undersigned), the Subscription Rights to subscribe for the number of Shares specified below under the Basic Subscription Right, and on behalf of beneficial owners of Subscription Rights who have exercised their Basic Subscription Rights in full, requests to subscribe for the number of additional Shares specified below pursuant to the Over-subscription Right, the terms of which are described further in the Prospectus, listing separately each exercised Basic Subscription Right and any corresponding Over-subscription Right as to each beneficial owner (without identifying any such beneficial owner) for whom the Nominee Holder is acting hereby:
 
NUMBER OF
SHARES OWNED
ON RECORD DATE
NUMBER OF SHARES
SUBSCRIBED FOR
PURSUANT TO BASIC
SUBSCRIPTION RIGHT
NUMBER OF SHARES
SUBSCRIBED FOR
PURSUANT TO
OVERSUBSCRIPTION RIGHT
 
 
 
_______________________________
_______________________________
_______________________________
 
 
 
_______________________________
_______________________________
_______________________________
 
 
 
_______________________________
_______________________________
_______________________________
 
 
 
_______________________________
_______________________________
_______________________________
 
 
 
_______________________________
_______________________________
_______________________________

____________________________________________
Name of Broker, Custodian Bank or Other Nominee
 

By:
 
____________________________________
Authorized Signature
 
  

 
 
 
 
 
Name:
 
_____________________________________
(please type or print)
 
  
             





 Provide the following information if applicable:
 
____________________________________________
Depository Trust Company (“DTC”) Participant Number
 
  
 
 
____________________________________________
Participant
 
  

By:
 
_______________________________________
 
  
Name:
 
_______________________________________
 
 
Title:
 
_______________________________________
 
 
               DTC Subscription Confirmation Numbers