HG Holdings, Inc. - FORM S-1/A - EX-99.7 - EXHIBIT 99.7 - October 15, 2010

Attached files

file filename
S-1/A - AMENDMENT #1 - HG Holdings, Inc.ds1a.htm
EX-4.3 - EXHIBIT 4.3 - HG Holdings, Inc.dex43.htm
EX-5.1 - EXHIBIT 5.1 - HG Holdings, Inc.dex51.htm
EX-4.4 - EXHIBIT 4.4 - HG Holdings, Inc.dex44.htm
EX-99.1 - EXHIBIT 99.1 - HG Holdings, Inc.dex991.htm
EX-23.1 - EXHIBIT 23.1 - HG Holdings, Inc.dex231.htm
EX-99.6 - EXHIBIT 99.6 - HG Holdings, Inc.dex996.htm
EX-99.2 - EXHIBIT 99.2 - HG Holdings, Inc.dex992.htm
EX-99.5 - EXHIBIT 99.5 - HG Holdings, Inc.dex995.htm
EX-99.3 - EXHIBIT 99.3 - HG Holdings, Inc.dex993.htm
EX-99.4 - EXHIBIT 99.4 - HG Holdings, Inc.dex994.htm

Exhibit 99.7

FORM OF

NOMINEE HOLDER CERTIFICATION

The undersigned, a bank, broker, trustee, depositary or other nominee of transferable rights (the “Rights”) to purchase shares of common stock, par value $0.02 per share, of Stanley Furniture Company, Inc. (the “Company”) pursuant to the rights offering described and provided for in the Company’s Prospectus dated [            ], 2010 (the “Prospectus”), hereby certifies to the Company and to Continental Stock Transfer & Trust Co., as Subscription Agent for such rights offering, that (1) the undersigned has exercised, on behalf of the beneficial owners thereof (which may include the undersigned), the number of Rights specified below pursuant to the Basic Subscription Privilege (as defined in the Prospectus) and, on behalf of beneficial owners of Rights who have subscribed for the purchase of additional shares of common stock pursuant to the Over-Subscription Privilege (as defined in the Prospectus), the number of shares specified below pursuant to the Over-Subscription Privilege, listing separately below each such exercised Basic Subscription Privilege and the corresponding Over-Subscription Privilege (without identifying any such beneficial owner), and (2) to the extent a beneficial owner has elected to subscribe for shares pursuant to the Over-Subscription Privilege, each such beneficial owner’s Basic Subscription Privilege has been exercised in full:

 

    

Number of Shares
Owned on
the Record Date

   

Number of Shares Subscribed for
Pursuant to Basic
Subscription Privilege

   

Number of Shares Subscribed for
Pursuant to
Over-Subscription Privilege

1.         
2.         
3.         
4.         
5.         
6.         
7.         
8.         
9.         

Provide the following information if applicable:

 

 

Depository Trust Company (“DTC”) Participant Number

 

Participant Name:                                                      

 

By:    
  Name:
  Title:

 

 

 

DTC Basic Subscription Confirmation Number(s)

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