Attached files
| file | filename |
|---|---|
| EX-99.8 - FORM OF SUBSCRIPTION RIGHTS STATEMENT - ON TRACK INNOVATIONS LTD | ea139571ex99-8_ontrackinno.htm |
| EX-99.7 - FORM OF NOTICE OF GUARANTEED DELIVERY - ON TRACK INNOVATIONS LTD | ea139571ex99-7_ontrackinno.htm |
| EX-99.5 - FORM OF BENEFICIAL OWNER ELECTION FORM - ON TRACK INNOVATIONS LTD | ea139571ex99-5_ontrackinno.htm |
| EX-99.4 - FORM OF BROKER LETTER TO CLIENTS WHO ARE BENEFICIAL HOLDERS - ON TRACK INNOVATIONS LTD | ea139571ex99-4_ontrackinno.htm |
| EX-99.3 - FORM OF LETTER TO BROKERS, DEALERS, BANKS AND OTHER NOMINEES - ON TRACK INNOVATIONS LTD | ea139571ex99-3_ontrackinno.htm |
| EX-99.2 - FORM OF LETTER TO SHAREHOLDERS WHO ARE RECORD HOLDERS - ON TRACK INNOVATIONS LTD | ea139571ex99-2_ontrackinno.htm |
| EX-99.1 - FORM OF INSTRUCTIONS AS TO USE OF SUBSCRIPTION RIGHTS STATEMENTS - ON TRACK INNOVATIONS LTD | ea139571ex99-1_ontrackinno.htm |
| S-1/A - AMENDMENT NO. 1 TO FORM S-1 - ON TRACK INNOVATIONS LTD | ea139571-s1a1_ontrackinno.htm |
Exhibit 99.6
FORM OF
NOMINEE HOLDER CERTIFICATION
ON TRACK INNOVATIONS, LTD.
The undersigned, a bank, broker, dealer, trustee, depositary, or other nominee of non-transferable subscription rights (the “Subscription Rights”) to purchase ordinary shares (“Shares”) of On Track Innovations, Ltd. (the “Company”), pursuant to the Subscription Rights offering described and provided for in the Company’s prospectus dated , 2021, (the “Prospectus”), hereby certifies to the Company and to Broadrige Corporate Issuer Solutions, 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 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 Shares pursuant to the Over-Subscription Privilege (as defined in the Prospectus), the number of Shares specified below, listing separately each such exercised Basic Subscription Right 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 Right has been exercised in full:
| Individual Soliciting |
Number
of Shares Owned on the Record Date |
Individual Soliciting Broker (if any) |
Number
of Shares Subscribed for Pursuant to the Basic Subscription Right |
Number
of Shares Subscribed for Pursuant to the Over-Subscription Privilege | |||||
| 1. | |||||||||
| 2. | |||||||||
| 3. | |||||||||
| 4. | |||||||||
| 5. | |||||||||
| 6. | |||||||||
| 7. | |||||||||
| 8. |
| Name of Nominee Holder | ||
| By: | ||
| Name: | ||
| Title: | ||
| Phone Number: | ||
| Fax Number: | ||
| Dated: | ||
| Provide the following information, if applicable: | ||
| DTC Participant Number | ||
| DTC Participant | ||
| By: | ||
| Name: | ||
| Title: | ||
| DTC Bank Subscription Confirmation Number(s) | ||
| Dated: | ||