FORM OF NOMINEE HOLDER CERTIFICATION
Published on September 15, 2017
Exhibit 99.7
HEAT BIOLOGICS, INC.
NOMINEE HOLDER CERTIFICATION
The undersigned, a broker, custodian bank, trustee, depositary or other nominee holder of subscription rights (the Rights) to purchase shares of common stock, par value $0.0002 per share (Common Stock), of Heat Biologics, Inc., a Delaware corporation (the Company), pursuant to the rights offering described and provided for in the Companys prospectus, dated [], 2017 (the Prospectus), hereby certifies to the Company and Continental Stock Transfer & Trust 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 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), 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 owners basic subscription privilege has been exercised in full if subscribing for the purchase of additional shares of Common Stock pursuant to the over-subscription privilege:
Number of Shares of Common Stock Held on the Record Date |
Number of Shares of Common Stock Into Which the Warrants Held by You Were Exercisable on the Record Date |
Rights Exercised Pursuant to Basic Subscription Privilege |
Number of Shares Subscribed For Pursuant to Over-Subscription Privilege |
|
|
|
|
|
|
1. |
|
|
|
|
|
|
|
|
|
2. |
|
|
|
|
|
|
|
|
|
3. |
|
|
|
|
|
|
|
|
|
4. |
|
|
|
|
|
|
|
|
|
Name of Undersigned:
By: _______________________________ (Authorized Signature)
Name:
Title:
Provide the following information if applicable:
Depository Trust Company (DTC) Participant Number:
Participant:
DTC Basic Subscription Confirmation Number(s):
|
|
|