Exhibit 99.(a).(1).(G)
XETA Technologies
Stock Option Exchange Program
Election Confirmation
Please print your confirmation page and retain it for your records.
XETA has received your Election Form which shows you have made the following selections:
Confirmation #: 0000000000 |
|
Date: [Month] [Day] 2009 00:00 m |
|
NAME
ADD
CITY, STATE ZIP
Selected |
| Plan under which |
| Grant |
| Exercise |
| # of |
| Status of Eligible |
| Expiration |
| |||
Option |
| were Granted |
| Date |
| Price |
| Options |
| Vested |
| Unvested |
| Date |
| |
Exchange |
| TEST123 |
| 0000-00-00 |
| $ | 0.00 |
| 000 |
| 0 |
| 0 |
| 0000-00-00 |
|
Do Not Exchange |
| TEST134 |
| 0000-00-00 |
| $ | 0.00 |
| 000 |
| 0 |
| 0 |
| 0000-00-00 |
|
You may change or withdraw this election any time before the Exchange Program expires. To do so, log back into the Exchange Program website and follow the Withdrawal Instructions. When you access your Election Form to change or withdraw your previous election, you will need to re-enter your selections for each of the option grants listed—not just those you wish to change or withdraw.
Please note that our receipt of your Election Form is not by itself an acceptance of your Eligible Option for exchange. We will be deemed to have accepted your Eligible Option for exchange when we have determined that the Eligible Option was validly tendered and not properly withdrawn, and we give you written notice that we have accepted such Eligible Option for exchange. Such notice may be made by email or other method of communication at our discretion.
The last Election Form properly submitted by you and received by us prior to the Exchange Program deadline will prevail.