Print Page  Close Window

SEC Filings

S-4/A
AVALON CABLE OF MICHIGAN INC/ filed this Form S-4/A on 05/28/1999
Entire Document
 
<PAGE>

                       Option of Holder to Elect Purchase

          If you want to elect to have this Senior Discount Note purchased by
the Issuers pursuant to Section 4.10 or 4.15 of the Indenture, check the box
below:

          [_] Section 4.10    [_] Section 4.15



          If you want to elect to have only part of the Senior Discount Note
purchased by the Issuers pursuant to Section 4.10 or Section 4.15 of the
Indenture, state the amount you elect to have purchased: $________

Date: _________________

                              Your Signature:__________________________________
                              (Sign exactly as your name appears on the face of
                              this Senior Discount Note)

                              Tax Identification No.:__________________________

                              SIGNATURE GUARANTEE:

                              ________________________

                              Signatures must be guaranteed by an "eligible
                              guarantor institution" meeting the requirements of
                              the Registrar, which requirements include
                              membership or participation in the Security
                              Transfer Agent Medallion Program ("STAMP") or such
                              other "signature guarantee program" as may be
                              determined by the Registrar in addition to, or in
                              substitution for, STAMP, all in accordance with
                              the Securities Exchange Act of 1934, as amended.


                                     A-12