Exhibit (a)(1)(Y)
XETA Technologies
Stock Option Exchange Program
Election Confirmation
(Paper Version)
XETA has received your paper 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 withdraw this election any time by using a paper Notice of Withdrawal form. To do so, complete, sign and submit the paper Notice of Withdrawal by facsimile to Kim Hodge at (918)588-4802, or by U.S. mail or courier addressed to XETA Technologies, Inc., Attention: Stock Option Exchange Program, 1814 W. Tacoma Street Broken Arrow, Oklahoma 74012. We must receive the Notice of Withdrawal before expiration of the Exchange Program for it to be effective. You may NOT withdraw a paper Election Form through the Exchange Program intranet website.
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Eligible Option for exchange when we have determined that the Eligible Option was validly tendered and not properly withdrawn, and we give you written notice that we have accepted such Eligible Option for exchange.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.