Healthier Choices Management Corp. - FORM S-1/A - EX-99.6 - FORM OF NOMINEE HOLDER CERTIFICATION

Attached files

file	filename
EX-99.7 - FORM OF NOTICE OF IMPORTANT TAX INFORMATION - Healthier Choices Management Corp.	ex99_7.htm
EX-99.5 - FORM OF BENEFICIAL OWNER ELECTION FORM - Healthier Choices Management Corp.	ex99_5.htm
EX-99.4 - FORM OF BROKER LETTER TO CLIENTS WHO ARE BENEFICIAL HOLDERS - Healthier Choices Management Corp.	ex99_4.htm
EX-99.3 - FORM OF LETTER TO BROKERS AND OTHER NOMINEE HOLDERS - Healthier Choices Management Corp.	ex99_3.htm
EX-99.2 - FORM OF LETTER TO STOCKHOLDERS WHO ARE RECORD HOLDERS - Healthier Choices Management Corp.	ex99_2.htm
EX-99.1 - FORM OF INSTRUCTIONS AS TO USE OF NON-TRANSFERABLE SUBSCRIPTION RIGHTS CERTIFICA - Healthier Choices Management Corp.	ex99_1.htm
EX-23.1 - CONSENT OF MARCUM LLP - Healthier Choices Management Corp.	ex23_1.htm
EX-5.1 - OPINION OF COZEN O'CONNOR P.C. - Healthier Choices Management Corp.	ex5_1.htm
EX-4.1 - FORM OF NON-TRANSFERABLE SUBSCRIPTION RIGHTS CERTIFICATE - Healthier Choices Management Corp.	ex4_1.htm
EX-1.1 - FORM OF DEALER MANAGER AGREEMENT - Healthier Choices Management Corp.	ex1_1.htm
S-1/A - FORM S-1/A - RIGHTS OFFERING AMENDMENT NO. 2 - Healthier Choices Management Corp.	forms1_a2021.htm

EXHIBIT 99.6

THE TERMS AND CONDITIONS OF THE RIGHTS OFFERING ARE SET FORTH IN THE COMPANY’S PROSPECTUS DATED MAY 18, 2021 (THE “PROSPECTUS”) AND ARE INCORPORATED HEREIN BY REFERENCE. COPIES OF THE PROSPECTUS ARE AVAILABLE UPON REQUEST FROM BROADRIDGE CORPORATE ISSUER SOLUTIONS, INC., THE SUBSCRIPTION AGENT, BY CALLING (888) 789-8409.

HEALTHIER CHOICES MANAGEMENT CORP.

SHARES OF COMMON STOCK

ISSUABLE UPON EXERCISE OF SUBSCRIPTION RIGHTS

NOMINEE HOLDER CERTIFICATION

The undersigned, a bank, broker, trustee, depository or other nominee holder of subscription rights (the “Subscription Rights”) to purchase shares of common stock, par value $0.0001 per share (“Common Stock”), of Healthier Choices Management Corp., a Delaware corporation (the “Company”), pursuant to the rights offering described in the Company’s prospectus dated May 18, 2021 (the “Prospectus”), hereby certifies to the Company and Broadridge Corporate Issuer Solutions, Inc., 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), Subscription Rights in the aggregate dollar amount 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 of Common Stock pursuant to the over-subscription right (as defined in the Prospectus), listing separately below the aggregate dollar amount of each such exercised basic subscription right and the corresponding over-subscription right (without identifying any such beneficial owner), and (2) each such beneficial owner’s basic subscription right has been exercised in full:

	NUMBER OF SHARES OWNED ON RECORD DATE	AGGREGATE DOLLAR AMOUNT SUBSCRIBED FOR PURSUANT TO BASIC SUBSCRIPTION RIGHT	AGGREGATE DOLLAR AMOUNT SUBSCRIBED FOR PURSUANT TO BASIC OVER‑SUBSCRIPTION RIGHT
1.
2.
3.
4.
5.

Name of Bank, Broker, Trustee, Depository or Other Nominee:

By:
	Authorized Signature
Name:
	(Please print or type)
Title
	(Please print or type)

Provide the following information if applicable:

Depository Trust Company (“DTC”) Participant Number

Participant:

By:
	Authorized Signature
Name:
	(Please print or type)
Title
	(Please print or type)

DTC Subscription Confirmation Number(s)

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