VERIFIED PROOF OF CLAIM FORM
Pursuant to order of the United States District Court for the Northern District of Ohio, Eastern Division, in Securities and Exchange Commission v. Lloyd E. Wollmershauser a/k/a The PennyStockMan (Civil Action No. 1:01CV530), all Verified Proof of Claim Forms must be ACTUALLY RECEIVED by the SEC no later than 5 p.m. (Mountain Standard Time) on August 27, 2001. Claimants who fail to meet this deadline will not receive any distributions of disgorged profits.
Verified Proof of Claim Forms must be sent or delivered to:
Ian S. Karpel
Facsimile and electronic copies will not be accepted. To receive an acknowledgement of the submission of your Verified Proof of Claim Form, enclose a copy of the completed form and a stamped, self-addressed envelope.
Please fully complete (print legibly or type) the following (if the space provided is insufficient, additional pages may be attached):
1. Name (or names if joint brokerage account(s)):
2. Home address:
3. Home telephone:
4. Business name and address:
5. Business telephone:
6. E-mail address (if available):
7. Complete the following:
8. You must include with this form a copy of the following:
(a) Monthly or other periodic brokerage account statements and/or confirmations evidencing your purchases and sales (if applicable) of Thermotek International, Inc. common stock on June 28, 2000 and/or June 29, 2000; and
(b) Evidence of payment for such Thermotek International, Inc. common stock.
If you fail to provide sufficient proof documenting your purchases and sales (if applicable) of Thermotek International, Inc. common stock, and payment thereof, you may be precluded from receiving any distributions of disgorged profits.
I (we) have personally completed this Verified Proof of Claim Form and acknowledge that I (we) am (are) fully aware of and understand the terms of the Verified Proof of Claim Form and of the Plan for Distribution of Disgorged Profits. I (we) hereby verify, under penalty of perjury, that the information and documentation in support of my (our) purchases (and sales if applicable) of Thermotek International, Inc. common stock which I (we) have submitted to the SEC is true, complete and accurate.