Incredimail 2010 Annual Report Download - page 187

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Yes 4 No 4
Yes 4 No 4
Yes 4 No 4
2.
Address for Notices to Selling Securityholder:
Telephone:
Fax:
Contact
Person:
3.
Beneficial Ownership of Registrable Securities:
Type and Principal Amount of Registrable Securities beneficially owned:
4.
Broker
-
Dealer Status:
(a)
Are you a broker
-
dealer?
Note:
If yes, the Commission
’
s staff has indicated that you should be identified as an underwriter in the Registration
Statement.
(b)
Are you an affiliate of a broker
-
dealer?
(c)
If you are an affiliate of a broker
-
dealer, do you certify that you bought the Registrable Securities in the ordinary
course of business, and at the time of the purchase of the Registrable Securities to be resold, you had no agreements
or understandings, directly or indirectly, with any person to distribute the Registrable Securities?
Note:
If no, the Commission
’
s staff has indicated that you should be identified as an underwriter in the Registration
Statement.
20