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FIRST SECURITY GROUP, INC.
NOMINEE HOLDER CERTIFICATION
The undersigned, a broker, custodian bank, trustee, depository or other nominee holder of subscription rights (the “Subscription Rights”) to purchase shares of common stock (“Common Stock”) of First Security Group, Inc. (“First Security”) pursuant to the rights offering (the “Rights Offering”) described and provided for in First Security's registration statement, as amended, and final prospectus dated ________, 2013 (the “Prospectus”), hereby certifies to First Security and Registrar and Transfer Company, as subscription agent for the Rights Offering, that (1) the undersigned has exercised, on behalf of the beneficial owners thereof (which may include the undersigned), the number of Subscription Rights specified below pursuant to the Basic Subscription Privilege (as defined in the Prospectus), and on behalf of beneficial owners of Subscription Rights who have subscribed for the purchase of additional shares of Common Stock pursuant to the Over-Subscription Privilege (as defined in the Prospectus), listing separately below each such exercised Basic Subscription Privilege and the corresponding Over-Subscription Privilege (without identifying any such beneficial owner), and (2) each such beneficial owner's Basic Subscription Privilege has been exercised in full if shares are subscribed for pursuant to the Over-Subscription Privilege:
Number of Shares of Common Stock Owned on the Record Date | Rights Exercised Pursuant to Basic Subscription Privilege | Number of Shares Subscribed for Pursuant to the Over-Subscription Privilege | |||
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Provide the following information if applicable:
Depository Trust Company (“DTC”) Participant Number | ||||
Participant Name | ||||
DTC Basic Subscription Confirmation Number(s) | ||||
Name of Broker, Custodian Bank, Trustee, Depository or Other Nominee | ||
By: | |
Name: | |
Title: | |