Attached files
| file | filename |
|---|---|
| S-1/A - FORM S-1 - SenesTech, Inc. | s111274_s1a.htm |
| EX-99.7 - EXHIBIT 99.7 - SenesTech, Inc. | s111274_ex99-7.htm |
| EX-99.5 - EXHIBIT 99.5 - SenesTech, Inc. | s111274_ex99-5.htm |
| EX-99.4 - EXHIBIT 99.4 - SenesTech, Inc. | s111274_ex99-4.htm |
| EX-99.3 - EXHIBIT 99.3 - SenesTech, Inc. | s111274_ex99-3.htm |
| EX-99.2 - EXHIBIT 99.2 - SenesTech, Inc. | s111274_ex99-2.htm |
| EX-99.1 - EXHIBIT 99.1 - SenesTech, Inc. | s111274_ex99-1.htm |
| EX-23.1 - EXHIBIT 23.1 - SenesTech, Inc. | s111274_ex23-1.htm |
| EX-4.3 - EXHIBIT 4.3 - SenesTech, Inc. | s111274_ex4-3.htm |
| EX-4.2 - EXHIBIT 4.2 - SenesTech, Inc. | s111274_ex4-2.htm |
Exhibit 99.6
FORM OF NOMINEE HOLDER CERTIFICATION
SENESTECH, INC.
The undersigned, a bank, broker, dealer, trustee, depositary, or other nominee of non-transferable subscription rights (the “Subscription Rights”) to purchase Units of SenesTech, Inc. (the “Company”), pursuant to the Rights Offering described and provided for in the Company’s Prospectus dated [______], 2018. Each Unit entitles the holder to one share of common stock of the Company, $0.001 par value (the “Common Stock”) and one Warrant. Each Warrant will be exercisable for one share of Common Stock. The undersigned hereby certifies to the Company and Broadridge Corporate Issuer Solutions, Inc., 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 Subscription Rights on the terms and subject to the conditions set forth in the Prospectus specified below pursuant to the Basic Subscription Right (as defined in the Prospectus) and, on behalf of beneficial owners of Subscription Rights who have subscribed for the purchase of additional Units pursuant to the Over-Subscription Right (as defined in the Prospectus), the number of Units specified below, listing separately below each such exercised Basic Subscription Right and the corresponding Over-Subscription Right (without identifying any such beneficial owner), and (2) to the extent a beneficial owner has elected to subscribe for Units pursuant to the Over-Subscription Right, each such beneficial owner’s Basic Subscription Right has been exercised in full:
| Number of Shares Owned or Deemed to be Owned on the Record Date | Individual Soliciting Broker (if any) |
Number of Units Subscribed for Pursuant to the Basic Subscription Right |
Number of Units Subscribed for Pursuant to the Over-Subscription Right |
| 1. | |||
| 2. | |||
| 3. | |||
| 4. | |||
| 5. | |||
By: ____________________________________ |
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Title: ___________________________________ |
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Fax Number: _____________________________ |
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Date: ___________________________________ |
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| Provide the following information, if applicable: | |||
DTC Participant: __________________________
DTC Participant Number: ________________________ |
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| By: _____________________________________ | |||
| Name: __________________________________ | |||
| Title: ___________________________________ | |||
DTC Basic Subscription Confirmation Number(s) _______________________________________________ |
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| Date: ___________________________________ | |||