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SC TO-T Filing
MediaAlpha (MAX) SC TO-TThird party tender offer statement
Filed: 26 May 23, 6:20am
| | THE OFFER, PRORATION PERIOD AND WITHDRAWAL RIGHTS WILL EXPIRE AT ONE MINUTE FOLLOWING 11:59 P.M., NEW YORK CITY TIME, ON MONDAY, JUNE 26, 2023, UNLESS THE OFFER IS EXTENDED OR TERMINATED (SUCH DATE AND TIME, AS THEY MAY BE EXTENDED, THE “EXPIRATION DATE”). | | |
| By Mail: | | | By Overnight Courier: | |
| Computershare Trust Company, N.A. c/o Voluntary Corporate Actions; COY: MAXX P.O. Box 43011 Providence, Rhode Island 02940 | | | Computershare Trust Company, N.A. c/o Voluntary Corporate Actions; COY: MAXX 150 Royall Street, Suite V Canton, Massachusetts 02021 | |
| | DESCRIPTION OF COMMON SHARES TENDERED (SEE INSTRUCTIONS 3 AND 4) | | | ||||||||||||
| | NAME(S) AND ADDRESS(ES) OF REGISTERED HOLDER(S) (PLEASE FILL IN, IF BLANK, EXACTLY AS NAME(S) APPEAR(S) ON SHARE CERTIFICATE(S) AND/OR ACCOUNT STATEMENT(S)) Please make any address correction below | | | | COMMON SHARES TENDERED (ATTACH ADDITIONAL SIGNED LIST, IF NECESSARY) | | | ||||||||
| | ☐ indicates permanent address change | | | | Certificate Number(s) and/or indicate Book- Entry | | | | Total Number of Common Shares Represented by Certificate(s)(1) | | | | Total Number of Common Shares Tendered(2)(3) | | |
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| | | | | | Total Common Shares Tendered | | | ||||||||
| | (1) Need not be completed by holders tendering by book-entry transfer. (2) If Common Shares are held in book-entry form, you MUST indicate the number of Common Shares you are tendering. (3) If you wish to tender fewer than all shares represented by any certificate listed above, please indicate in this column the number of Common Shares you wish to tender. Otherwise, all Common Shares represented by share certificates delivered to the Depositary will be deemed to have been tendered. See Instruction 4. ☐ Lost Certificates. I have lost my certificate(s) for Common Shares and I require assistance in replacing the Common Shares (See Instruction 12). | | |
| 1st: | | | 2nd: | | | 3rd: | |
| 4th: | | | 5th: | | | 6th: | |
| | SPECIAL DELIVERY INSTRUCTIONS (See Instructions 1, 6, 7 and 8) | | |
| | To be completed ONLY if the check for the aggregate purchase price of Common Shares purchased and/or certificates for Common Shares not tendered or not purchased are to be mailed to someone other than the undersigned or to the undersigned at an address other than that shown below the undersigned’s signature. | | |
| | Mail: | | |
| | Name: (please print) | | |
| | Address: (please include Zip Code) | | |
| | SPECIAL PAYMENT INSTRUCTIONS (See Instructions 1, 6, 7 and 8) | | |
| | To be completed ONLY if the check for payment of the purchase price of Common Shares accepted for payment and/or certificates for Common Shares not tendered or not purchased are to be issued in the name of someone other than the undersigned. | | |
| | Issue: | | |
| | Name: (please print) | | |
| | Address: (please include Zip Code) | | |
Signature(s) of Owner(s): | |
| Name(s): (Please Print) | |
| Capacity (full title): | |
| Address: (Include Zip Code) | |
| Name of Firm: (Include Zip Code) | |
| Authorized Signature: | |
| Name: (Please Type or Print) | |
| Area Code and Telephone Number: | |
| By Mail: Computershare Trust Company, N.A. c/o Voluntary Corporate Actions; COY: MAXX P.O. Box 43011 Providence, Rhode Island 02940 | | | By Overnight Courier: Computershare Trust Company, N.A. c/o Voluntary Corporate Actions; COY: MAXX 150 Royall Street, Suite V Canton, Massachusetts 02021 | |