Document:

Unassociated Document

 Exhibit 4.3

	
NUMBER

	
(SEE REVERSE SIDE FOR LEGEND)

	
WARRANTS

	
_____-

	
THIS WARRANT WILL BE VOID IF NOT EXERCISED PRIOR TO 5:00 P.M. NEW YORK CITY TIME, DECEMBER 31, 2013

	
 

	  	  	  
	
 

	
USA TECHNOLOGIES, INC.

	
CUSIP

	
 

	
 

	
_______

WARRANT

 

THIS CERTIFIES THAT, for value received ______________________________________ is the registered holder of a Warrant or Warrants expiring December 31, 2013 (the “Warrant”) to purchase one fully paid and non-assessable share of Common Stock, no par value (“Shares”), of USA Technologies, Inc., a Pennsylvania corporation (the “Company”), for each Warrant evidenced by this Warrant Certificate. The Warrant entitles the holder thereof to purchase from the Company, commencing on January 1, 2011, such number of Shares of the Company at the price of $___ per share, upon surrender of this Warrant Certificate and payment of the Warrant Price at the office or agency of the Warrant Agent, American Stock Transfer & Trust Company, LLC but only subject to the conditions set forth herein and in the Warrant Agreement between the Company and American Stock Transfer & Trust Company, LLC (as may be amended from time to time, the “Warrant Agreement”). In no event will the Company be required to net cash settle the warrant exercise. The Warrant Agreement provides that upon the occurrence of certain events the Warrant Price and the number of Warrant Shares purchasable hereunder, set forth on the face hereof, may, subject to certain conditions, be adjusted. The term Warrant Price as used in this Warrant Certificate refers to the price per Share at which Shares may be purchased at the time the Warrant is exercised.

 

No fraction of a Share will be issued upon any exercise of a Warrant. If the holder of a Warrant would be entitled to receive a fraction of a Share upon any exercise of a Warrant, the Company shall, upon such exercise round up or down to the nearest whole number the number of Shares to be issued to such holder.

 

Upon any exercise of the Warrant for less than the total number of full Shares provided for herein, there shall be issued to the registered holder hereof or the registered holder’s assignee a new Warrant Certificate covering the number of Shares for which the Warrant has not been exercised.

 

Warrant Certificates, when surrendered at the office or agency of the Warrant Agent by the registered holder hereof in person or by attorney duly authorized in writing, may be exchanged in the manner and subject to the limitations provided in the Warrant Agreement, but without payment of any service charge, for another Warrant Certificate or Warrant Certificates of like tenor and evidencing in the aggregate a like number of Warrants.

Upon due presentment for registration of transfer of the Warrant Certificate at the office or agency of the Warrant Agent, a new Warrant Certificate or Warrant Certificates of like tenor and evidencing in the aggregate a like number of Warrants shall be issued to the transferee in exchange for this Warrant Certificate, subject to the limitations provided in the Warrant Agreement, without charge except for any applicable tax or other governmental charge.

 

The Company and the Warrant Agent may deem and treat the registered holder as the absolute owner of this Warrant Certificate (notwithstanding any notation of ownership or other writing hereon made by anyone), for the purpose of any exercise hereof, of any distribution to the registered holder, and for all other purposes, and neither the Company nor the Warrant Agent shall be affected by any notice to the contrary.

 

This Warrant does not entitle the registered holder to any of the rights of a shareholder of the Company.

 

	
 

	
 

	
 

	
USA TECHNOLOGIES, INC.

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
By:

	
 

	
 

	
By:

	
 

	
 

	
 

	
Secretary

	
 

	
 

	
Chief Executive Officer

	
 

 

  

1

  

 

SUBSCRIPTION FORM

To Be Executed by the Registered Holder in Order to Exercise Warrants

The undersigned Registered Holder irrevocably elects to exercise _________ Warrants represented by this Warrant Certificate, and to purchase the shares of Common Stock issuable upon the exercise of such Warrants, and requests that Certificates for such shares shall be issued in the name of

 

	  
	
(PLEASE TYPE OR PRINT NAME AND ADDRESS)

	  
	
(SOCIAL SECURITY OR TAX IDENTIFICATION NUMBER)

 

	
and be delivered to

	
 

	
 

	
 

	
 

	
(PLEASE PRINT OR TYPE NAME AND ADDRESS)

 

	  
	
and, if such number of Warrants shall not be all the Warrants evidenced by this Warrant Certificate, that a new Warrant Certificate for the balance of such Warrants be registered in the name of, and delivered to, the Registered Holder at the address stated below:

	
Dated:

	
 

	
 

	
 

	
 

	
 

	
 

	
(SIGNATURE)

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
(ADDRESS)

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
(SOCIAL SECURITY OR TAX IDENTIFICATION NUMBER)

ASSIGNMENT

To Be Executed by the Registered Holder in Order to Assign Warrants

For Value Received, ____________________________ hereby sells, assigns, and transfers unto

 

	  
	
(PLEASE TYPE OR PRINT NAME AND ADDRESS)

	
 

	  

(SOCIAL SECURITY OR TAX IDENTIFICATION NUMBER)

	
and be delivered to

	
 

	
 

	
 

	
 

	
(PLEASE PRINT OR TYPE NAME AND ADDRESS)

___________ of the Warrants represented by this Warrant Certificate, and hereby irrevocably constitutes and appoints __________________________ Attorney to transfer this Warrant Certificate on the books of the Company, with full power of substitution in the premises.

 

 

	
Dated:

	
 

	
 

	
 

	
 

	
 

	
 

	
 

	
(SIGNATURE)

	
 

THE SIGNATURE TO THE ASSIGNMENT OF THE SUBSCRIPTION FORM MUST CORRESPOND TO THE NAME WRITTEN UPON THE FACE OF THIS WARRANT CERTIFICATE IN EVERY PARTICULAR, WITHOUT ALTERATION OR ENLARGEMENT OR ANY CHANGE WHATSOEVER, AND MUST BE GUARANTEED BY A COMMERCIAL BANK OR TRUST COMPANY OR A MEMBER FIRM OF THE AMERICAN STOCK EXCHANGE, NEW YORK STOCK EXCHANGE, PACIFIC STOCK EXCHANGE OR CHICAGO STOCK EXCHANGE.

 

 

2ex4_4.htm

Exhibit 4.4

 

	
RIGHTS CERTIFICATE #:

	
NUMBER OF RIGHTS

	  	
THE TERMS AND CONDITIONS OF THE RIGHTS OFFERING ARE SET FORTH IN THE COMPANY'S PROSPECTUS DATED ______, 2010 (THE "PROSPECTUS") AND ARE INCORPORATED HEREIN BY REFERENCE. COPIES OF THE PROSPECTUS ARE AVAILABLE UPON REQUEST FROM MACKENZIE PARTNERS, INC., THE INFORMATION AGENT.

	  
	 	 	 
	 	 	 

	
USA TECHNOLOGIES, INC.

Incorporated under the laws of the Commonwealth of Pennsylvania

 

NON-TRANSFERABLE SUBSCRIPTION RIGHTS CERTIFICATE

 

Evidencing Non-Transferable Subscription Rights to Purchase Shares of Common Stock of USA Technologies, Inc. and Related

Warrants to Purchase Shares of Common Stock of USA Technologies, Inc.

 

Subscription Price:  $____ per Share and Related Warrant

 

THE SUBSCRIPTION RIGHTS WILL EXPIRE IF NOT EXERCISED ON OR BEFORE 5:00 P.M., NEW YORK CITY TIME,

ON _______, 2010, UNLESS EXTENDED BY THE COMPANY

	 	 
	 	 
	 	 
	
REGISTERED

	  
	
OWNER:

	  

	 	 	 
	 	  	 
	 	  	 
	 	  	 
	 	  	 
	 	  	 
	 	
THIS CERTIFIES THAT the registered owner whose name is inscribed hereon is the owner of the number of non-transferable subscription rights (“Rights”) set forth above. Each whole Right entitles the holder thereof to subscribe for and purchase one share of Common Stock, no par value, of USA Technologies, Inc. (“Share”), and one related warrant to purchase one Share (“Warrant”) at a subscription price of $____ (the “Subscription Right”), pursuant to a Rights Offering (the “Rights Offering”), on the terms and subject to the conditions set forth in the Prospectus and the “Instructions as to Use of Subscription Rights Certificates” accompanying this Subscription Rights Certificate. The Rights represented by the Subscription Rights Certificate may be exercised by completing Form 1 and any other appropriate forms on the reverse side hereof and by returning the full payment of the subscription price for each Share and related Warrant in accordance with the “Instructions as to Use of Subscription Rights Certificate” that accompany this Subscription Rights Certificate.

	 
	 	
 

	 
	 	
This Subscription Rights Certificate is not valid unless countersigned by the subscription agent and registered by the registrar.

	 
	 	  	 
	 	
Witness the seal of USA Technologies, Inc. and the signatures of its duly authorized officers.

	 
	 	  	 
	 	
Dated: _______, 2010

	 
	 	  	 
	 	 	 

	  	  	 	  	  	  
	
Chairman and

Chief Executive Officer

	
President, Chief Operating Officer

and Secretary

	 	 
	 	 

 

  

  

  

 

DELIVERY OPTIONS FOR SUBSCRIPTION RIGHTS CERTIFICATE

Delivery other than in the manner or to the addresses listed below will not constitute valid delivery.

 

	
If delivering by mail:

American Stock Transfer & Trust Company

Attn: Reorganization Department

P.O. Box 2042

New York, New York 10272-2042

	  	
If delivering by hand or overnight courier:

American Stock Transfer & Trust Company

Operations Center

Attn: Reorganization Department

6201 15th Avenue

Brooklyn, New York 11219

PLEASE PRINT ALL INFORMATION CLEARLY AND LEGIBLY.

	
FORM 1-EXERCISE OF SUBSCRIPTION RIGHTS

	 	
FORM 3-SIGNATURE

	  	  	  	 	  
	
To subscribe for Shares and related Warrants pursuant to your Subscription Right, please complete the items (a) and (b) and sign under Form 3 below.

 

(a) EXERCISE OF SUBSCRIPTION RIGHT:

 

I apply for _______ Shares & related Warrants  x $____  =   $___________

 

    (no. of new Shares & Warrants)          (subscription price)  (amt enclosed)

 

(b) METHOD OF PAYMENT (CHECK ONE)

	 	
TO SUBSCRIBE: I acknowledge that I have received the Prospectus for this Rights Offering and I hereby irrevocably subscribe for the number of Shares and related Warrants indicated above on the terms and conditions specified in the Prospectus.   

 

Signature(s):   ______________________________________

 

IMPORTANT: The signature(s) must correspond with the name(s) as printed on the reverse of this Subscription Rights Certificate in every particular, without alteration or enlargement, or any other change whatsoever. 

 

FORM 4-SIGNATURE GUARANTEE

 

This form must be completed if you have completed any portion of Form 2.

 

Signature 

Guaranteed:_________________________________________ 

  (Name of Bank or Firm)

 

By: ________________________________________________

  (Signature of Officer)

 

IMPORTANT:  The signature(s) should be guaranteed by an eligible guarantor institution (bank, stockbroker, savings & loan association or credit union) with membership in an approved signature guarantee medallion program pursuant to Securities and Exchange Commission Rule 17Ad-15.

	  	  	  	 
	
£

	
Check or bank draft drawn on a U.S. bank payable to “American Stock Transfer FBO USA Technologies, Inc.” Funds paid by an uncertified check may take at least five business days to clear.

	 
	  	  	  	 
	
£

	
Wire transfer of immediately available funds directly to wire transfer to JP Morgan Chase, ABA No. 021000021, Account No. 530-354616, Account name: American Stock Transfer FBO USA Technologies, Inc.

	 
	  	  	  	 
	
FORM 2-DELIVERY TO DIFFERENT ADDRESS

	 
	  	  	  	 
	
If you wish for the Shares and related Warrants underlying your Rights or a certificate representing unexercised Rights to be delivered to an address different from that shown on the face of this Subscription Rights Certificate, please enter the alternate address below, sign under Form 3 and have your signature guaranteed under Form 4.

	 
	  	  	 
	  	  	 
	  	  	 
	  	  	 

FOR ADDITIONAL INSTRUCTIONS ON THE USE OF USA TECHNOLOGIES, INC. SUBSCRIPTION RIGHTS CERTIFICATES, CONSULT MACKENZIE PARTNERS, INC., THE INFORMATION AGENT, AT (212) 929-5500 (CALL COLLECT) or (800) 322-2885 (TOLL-FREE). YOU MAY ALSO E-MAIL OUR INFORMATION AGENT AT USATRIGHTS@MACKENZIEPARTNERS.COM.

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