Incredimail 2010 Annual Report Download - page 186
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Annex B
INCREDIMAIL LTD.
Selling Securityholder Notice and Questionnaire
The undersigned beneficial owner of common stock (the “Common Stock” ), of IncrediMail Ltd., an Israeli corporation (the “Company”
),
understands that the Company has filed or intends to file with the Securities and Exchange Commission (the “Commission” )
a Registration
Statement for the registration and resale of the Registrable Securities, in accordance with the terms of the Registration Rights Agreement, dated
as of January __, 2011 (the “Registration Rights Agreement” ),
among the Company and the Investors named therein. A copy of the
Registration Rights Agreement is available from the Company upon request at the address set forth below. All capitalized terms used and not
otherwise defined herein shall have the meanings ascribed thereto in the Registration Rights Agreement.
This questionnaire is being furnished to all Holders (as such term is defined in the Registration rights Agreement) and relates to certain
information required to be disclosed in the Registration Statement.
Selling stockholders of the Company may be personally liable under the federal securities laws of the United States if the Registration Statement
contains any statement which is false or misleading as to any material fact or omits to state any material fact necessary in order to make the
statements therein not false or misleading.
Your careful completion of this Questionnaire will help ensure that the Registration Statement will be complete and accurate. Careful
consideration of the instructions and definitions contained in the endnotes to various items is essential to an understanding of the questions.
The undersigned hereby provides the following information to the Company and represents and warrants that such information is accurate:
QUESTIONNAIRE
1.
Name.
(a)
Full Legal Name of Selling Securityholder
(b)
Full Legal Name of Registered Holder (if not the same as (a) above) through which Registrable Securities Listed in
Item 3 below are held:
(c)
Full Legal Name of Natural Control Person (which means a natural person who directly or indirectly alone or with
others has power to vote or dispose of the securities covered by the questionnaire):
19