Exhibit 99.5
BENEFICIAL OWNER ELECTION FORM
The undersigned acknowledge(s) receipt of your letter and the enclosed materials relating to the grant ofnon-transferable subscription rights (the “Rights”) to subscribe for and to purchase shares of common stock, par value $0.0075 per share (the “Common Stock”), of XOMA Corporation (the “Company”) for a cash purchase price of $13.00 per share. Any holder of greater than 9.9% of the outstanding number of shares of the Common Stock may elect to instead purchasenon-voting Series Y Preferred Stock at a purchase price of $13,000 per share, and any such holder so electing would have a right to purchase oneone-thousandth of a share of Series Y Preferred Stock for each share of Common Stock it had a right to purchase in the Rights Offering, as described in the Prospectus.
With respect to any instructions to exercise (or not to exercise) Rights, the undersigned acknowledges that this form must be completed and returned such that it will actually be received by you by 5:00 p.m., New York City time, on December 13, 2018, the last business day prior to the scheduled expiration date of the rights offering of December 14, 2018 (which may be extended by the Company).
This will instruct you whether to exercise the Rights to purchase shares of Common Stock distributed with respect to the shares of Common Stock held through you as broker, dealer, custodian bank or other nominee for the account of the undersigned, pursuant to the terms and subject to the conditions set forth in the prospectus supplement (and accompanying prospectus) datedNovember 19, 2018 (the “Prospectus”), and the related “Instructions as to Use of XOMA Corporation Rights Certificates.”
I (we) hereby instruct you as follows:
(CHECK THE APPLICABLE BOXES AND PROVIDE ALL REQUIRED INFORMATION)
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Box 1. ☐ | | Please DO NOT EXERCISE RIGHTS. |
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Box 2. ☐ | | Please EXERCISE RIGHTS as set forth below: |
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| | Number of Shares of Common Stock Subscribed For | | | | Subscription Price | | | | | Payment |
Common Subscription Right | | | | x | | $13.00 | | | = | | | $ |
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| | Number of Shares of non-voting Series Y Preferred Stock Subscribed For | | | | Subscription Price | | | | | Payment |
Preferred Subscription Right (for holders of greater than 9.9% of the Company’s outstanding common shares): | | | | x | | $13,000.00 | | | = | | | $ |
If you are NOT a holder of greater than 9.9% of the outstanding common shares and you apply to purchase shares ofnon-voting Series Y Preferred Stock, you will not receive any, but will instead receive an equivalent number of shares of common stock (on an as-converted basis) in consideration for the same purchase price.