50 Ill. Adm. Code 203.EXHIBIT A
A Information Required in Proxy Statement or Information Statement
Section 203
Section 203.EXHIBIT A Information
Required in Proxy Statement or Information Statement
Item 1. Revocability
of Proxy
State whether
or not the person giving the proxy has the power to revoke it. If the right of
revocation before the proxy is exercised is limited or is subject to compliance
with any formal procedure, briefly describe that limitation or procedure.
Item 2. Dissenters'
Rights of Appraisal.
Outline
briefly the rights of appraisal or similar rights of dissenting security
holders concerning any matter to be acted upon and indicate any statutory
procedure required to be followed by those security holders in order to perfect
their rights. Where those rights may be exercised only within a limited time
after the date of the adoption of a proposal, the filing of an amendment to
Articles of Incorporation, or other similar act, state whether the person
solicited will be notified of such date.
Item 3. Persons
Making Solicitation Not Subject to Section 203.100
a) If the solicitation is made by the management of the company,
so state. Give the name of any director of the company who has informed the
management in writing that he intends to oppose any action intended to be taken
by the management and indicate the action which he intends to oppose.
b) If the solicitation is made other than by the management of
the company, state the names and addresses of the persons by whom and on whose
behalf it is made and the names and addresses of the persons by whom the cost
of solicitation has been or will be borne, directly or indirectly.
c) If the solicitation is to be made by specially engaged
employees or paid solicitors, state (i) the material features of any contract
or arrangement for the solicitation and identify the parties, and (ii) the cost
or anticipated cost thereof.
Item 4. Interest of
Certain Persons in Matters to Be Acted Upon.
Describe
briefly any substantial interests, directly or indirectly, by security holdings
or otherwise, of any director, nominee for election as director, officer and,
if the solicitation is made other than on behalf of management, each person on
whose behalf the solicitation is made, in any matter to be acted upon, other
than elections to office.
Item 5. Voting
Securities
a) State, as to each class of voting securities of the company
entitled to be voted at the meeting, the number of shares outstanding and the
number of votes to which each class is entitled.
b) Give the date as of which the record list of security holders
entitled to vote at the meeting will be determined. If the right to vote is
not limited to security holders of record on that date, indicate the conditions
under which other security holders may be entitled to vote.
c) If action is to be taken concerning the election of directors
and if the persons solicited have cumulative voting rights, make a statement
that they have such rights and state briefly the conditions precedent to the
exercise of those rights.
Item 6. Nominees and
Directors
If action is to
be taken concerning the election of directors, furnish the following
information, in tabular form to the extent practical, with respect to each
person nominated for election as a director and each other person whose term of
office as a director will continue after the meeting:
a) Name each person, state when his term of office or the term of
office for which he is a nominee will expire, and all other positions and
offices with the company presently held by him, and indicate which persons are
nominees for election as directors at the meeting;
b) State his present principal occupation or employment and the
name and principal business of any corporation or other organization by which
he is employed. Furnish similar information as to all of his principal occupations
or employments during the last 5 years, unless he is now a director and was
elected to his present term of office by a vote of security holders at a
meeting for which proxies were solicited under this regulation;
c) If he is or has previously been a director of the company,
state the period or periods during which he served as a director of the
company; and
d) State, as of the most recent practical date, the approximate
number of shares of each class of equity securities of the company or any of
its parents, subsidiaries or affiliates other than director's qualifying
shares, beneficially owned directly or indirectly by him. If he is not the
beneficial owner of any of those securities, make a statement to that effect.
Item 7. Remuneration
and other Transactions With Management and Others.
Furnish the
information reported or required in Item One of Schedule SIS of the annual
statement form as prescribed by the N.A.I.C. under the heading
"Information Regarding management and Directors" if action is to be
taken concerning (a) the election of directors, (b) any remuneration plan,
contract or arrangement in which any director, nominee for election as a
director, or officer of the company will participate, (c) any pension or
retirement plan in which any such person will participate, or (d) the granting
or extension to any such person of any options, warrants or rights to purchase
any securities, other than warrants or rights issued to all security holders on
a pro rata basis. If the solicitation is made on behalf of persons other than
the management, information need be furnished only as to Item 1A of the
described heading of Schedule SIS.
Item 8. Bonus,
Profit Sharing and Other Remuneration Plans.
If action is
to be taken concerning any bonus, profit sharing, or other remuneration plan of
the company, furnish the following information:
a) A brief description of the material features of the plan, each
class of persons who will participate in the plan, the approximate number of
persons in each class, and the basis of participation;
b) The amounts which would have been distributable under the plan
during the last calendar year to (1) each person named in Item 7 of this
Exhibit, (2) directors and officers as a group, and (3) all other employees as
a group, if the plan had been in effect as to other employees; and
c) If the plan to be acted upon may be amended (other than by a
vote of security holders) in a manner which would materially increase the cost
to the company or would materially alter the allocation of the benefits as
between the groups specified in paragraph (b) of this Item, the nature of the
amendments must be specified.
Item 9. Pension and
Retirement Plans.
If action is
to be taken concerning any pension or retirement plan of the company, furnish
the following information:
a) A brief description of the material features of the plan, each
class of persons who will participate in the plan, the approximate number of
persons in each class, and the basis of participation;
b) State (1) the approximate total amount necessary to fund the
plan with respect to past services, the period over which the amount is to be
paid, and the estimated annual payments necessary to pay the total amount over
the period; (2) the estimated annual payment to be made for current services;
and (3) the amount of the annual payments to be made for the benefit of (i)
each person named in Item 7 of this Exhibit, (ii) directors and officers as a
group and (iii) employees as a group; and
c) If the plan to be acted upon may be amended (other than by a
vote of security holders) in a manner which would materially increase the cost
thereof to the company or would materially alter the allocation of the benefits
between the groups specified in sub-paragraph (3) of sub-paragraph (b) of this
Item, the nature of the amendments must be specified.
Item 10. Options,
Warrants, or Rights.
If action is
to be taken concerning the granting or extension of any options, warrants or
rights (all referred to in this Item as "warrants") to purchase
equity securities of the company or any subsidiary or affiliate, other than
warrants issued to all security holders on a pro rate basis, furnish the
following information:
a) The title and number of shares of securities called for or to
be called for, the prices, expiration dates and other material conditions upon
which the warrants may be exercised, the consideration received or to be
received by the company, subsidiary or affiliate for the granting or extension
of the warrants and the market value of the securities called for or to be
called for by the warrants, as of the latest practical date;
b) If known, state separately the total number of shares of
securities called for or to be called for by warrants received or to be received
by the following persons, naming each person: (1) each person named in Item 7
of this Exhibit, and (2) each other person who will be entitled to acquire 5
per cent or more of the securities called for or to be called for by the
warrants; and
c) If known, state also the total number of shares of securities
called for or to be called for by the warrants received or to be received by
all directors and officers of the company as a group and all employees, without
naming them.
Item 11. Authorization
or Issuance of Securities.
a) If action is to be taken concerning the authorization or
issuance of any securities of the company, furnish the title, number of shares
or total face amount, as applicable, and description of the securities to be
authorized or issued.
b) If the securities are other than additional shares of common
stock of a class outstanding, furnish a brief summary of the following, as
applicable: dividend, voting, liquidation, preemptive, and conversion rights,
redemption and sinking fund provisions, interest rate and date of maturity.
c) If the securities to be authorized or issued are other than
additional shares of common stock of a class outstanding, the Director may
require financial statements comparable to those contained in the annual
report.
Item 12. Mergers,
Consolidations, Acquisitions and Similar Matters.
a) If action is to be taken concerning a merger, consolidation,
acquisition, or similar matter, furnish in brief outline the following
information:
1) The rights of appraisal or similar rights of dissenters with
respect to any matters to be acted upon. Indicate any procedure required to be
followed by dissenting security holders in order to perfect their rights;
2) The material features of the plan or agreement;
3) The business done by the company to be acquired or whose
assets are being acquired;
4) If available, the high and low sale prices of all outstanding
securities issued by each company involved for each quarterly period within 2
years; and
5) The percentage of outstanding shares which must approve the
transaction before it is consummated.
b) For each company involved in a merger, consolidation or
acquisition, the following financial statements must be furnished;
1) A comparative balance sheet as of the close of the last 2
fiscal years;
2) A comparative statement of operating income and expenses for
each of the last 2 fiscal years and, as a continuation of each statement, a
statement of earnings per share after related taxes and cash dividends paid per
share; and
3) A pro forma combined balance sheet and income and expense
statement for the last fiscal year giving effect to the necessary adjustments
with respect to the resulting company.
Item 13. Restatement
of Accounts.
If action is
to be taken concerning the restatement of an asset, capital, or surplus account
of the company, furnish the following information:
a) State the nature of the restatement and the date as of which
it is to be effective;
b) Outline briefly the reasons for the restatement and for the
selection of the particular effective date; and
c) State the name and amount of each account affected by the
restatement and the effect of the restatement on each account.
Item 14. Matters Not
Required to Be Submitted.
If action is
to be taken concerning any matter which is not required to be submitted to a
vote of security holders, state the nature of the matter, the reason for
submitting it to a vote of security holders and what action is intended to be
taken by the management in the event of a negative vote on the matter by the
security holders.
Item 15. Amendment of
Articles of Incorporation, By-Laws, or Other Documents.
If action is
to be taken concerning any amendment to the company's Articles of
Incorporation, By-Laws or other documents about which information is not
otherwise required in this Exhibit, state briefly the reasons for and general
effect of the amendment and the vote required for its approval.