"Estate Claim Release"
Electronic Filing To file your claim electronically, click the Excel Efile Template (above) for the proper format. Instructions: 1. Click on the Excel Efile Template link above. 2. Save the file on your computer. 3. Open the file with Microsoft Excel and fill it in. 4. Additionally, please follow the instructions in the Notice Packet. Important Notes: This format is used for Institutions, Brokers and Nominees only. This is not used for Individual potentia PDF files are not accepted for electronic filing. Only a completed Excel Efile Template worksheet will b Please fill out one "Master" or "Umbrella" Proof of Claim and Release entirely, and attach a list of accou filing on behalf. We do request that you either mail the electronic data (CD) with the Proof of Claim to the a (no emails) or upload it to our secured FTP site. Please submit documents showing you have authority to f your clients, and submit a statement that discloses the source of the data contained on the data file (i.e. whe extracted from such as a Broker's proprietary database). **PLEASE NOTE - AS OF JUNE 20, 2006, THE TICKER CHANGED FROM XTHN (OTCBB) TO XNL (AMEX). If you would like to mail the via courier, please use the address below. In re Xethanol Corporation Securities Litigation Settlement c/o Complete Claim Solutions, LLC 5210 Hood Road Palm Beach Gardens, FL 33418 If you would like to upload your claim to a secured FTP site, please contact us at (877) 625-9442 and we will prov per format. is not used for Individual potential claimants. el Efile Template worksheet will be accepted. entirely, and attach a list of account names you are D) with the Proof of Claim to the address provided s showing you have authority to file on behalf of contained on the data file (i.e. where the data was BB) TO XNL (AMEX). (877) 625-9442 and we will provide that information to you. Zale Electronic Claim Format Column Heading Description Last Name Beneficial Owner 1 (Individual, Joint, or IRA accounts Last name of Beneficial Owner - Individual or Joint Accounts only. If IRA and you want ONLY) the check made out to IRA, use the following format: JONES IRA 2 First Name Beneficial Owner First name of Beneficial Owner 3 Last Name of Co-Owner, if applicable Last Name of Co-Owner (if applicable) 4 First Name of Co-Owner, if applicable First name of Co-Owner Name of Company, Trust, Estate, etc. THIS COLUMN SHOULD NEVER BE 5 Entity Name POPULATED IF COLUMN 1 (Last Name Beneficial Owner - for Individual, Joint, or IRA accounts Only) IS POPULATED Representative Name, if applicable (e.g. executor, custodian, trustee, administrator, 6 Representative Name nominee,etc) 7 Addr1 Addr1 8 Addr2 Addr2 9 City City 10 State State 11 Zip5 Zip5 12 Zip4 Zip4 13 Account # Account Number 14 Tax Id # Acct holders Tax Id or SSN 15 CUSIP Security Cusip B = Beginning Balance as of 01/31/2006 P = Open Market Purchases from 1/31/2006 through 8/8/2006 PR = Free Receipt Transfer into this account from 01/31/2006 through 08/08/2006 16 Type P2= Total Number of Shares Purchased 08/09/2006 to 08/16/2006 S = Open Market Sales from 01/31/2006 through 08/15/2006 SD = Free Delivery Transfer to another account from 01/31/2006 through 08/15/2006 U = Unsold Shares - Balance as of 08/16/2006 (one record per acct per security code) Common Stock = "XLN" 17 Security Code Cusip 98420A103 18 Trade Date Transaction Date 19 Shares Qty of shares for Common Stock 20 Price/Share Price per share for Common Stock Total Amount Paid for Purchases; Total Amount Received for Sales; leave blank for all 21 Net Amount others Instructions: > Columns 1 thru 4 are for Individual, Joint, or IRA accounts only > Column 5 is for Entities (Corporations, Estates, Trusts, etc.) only > EITHER Column 1-4 OR Column 5 should be populated - NEVER all 5 Columns > Columns 7 through 19 are required for every transaction. > Only ONE Beginning Balance and ONE Unsold Shares transaction per Acct # > Please use mm/dd/yyyy format for all date fields > For fields 16 and 17 please use provided abbreviations Beneficial Owner Last Name Entity Name (Individual, Joint, or IRA accounts Beneficial Owner Co-Owner Co-Owner (Corporation, Rep name (e.g. Custodian, only) First Name Last Name First Name Estate, Trust, etc.) Trustee, Executor, etc.) Addr1 Addr2 City State Zip5 Zip4 Account # Tax Id # CUSIP Type Security Code Trade Date # of Shares Price/Share Amt Pd or Rec'd. Beneficial Owner Last Name (Individual, Joint, or IRA Beneficial Entity Name Rep name (e.g. accounts Owner First Co-Owner Co-Owner (Corporation, Custodian, only) Name Last Name First Name Estate, Trust, etc.) Trustee, Executor, etc.) Smith John Smith John Smith John Smith John Smith John XYZ Corporations Attn: John Doe, President XYZ Corporations Attn: John Doe, President XYZ Corporations Attn: John Doe, President Simmons Bob Simmons Betty Simmons Bob Simmons Betty Jones IRA Robert ABC Bank, Custodian Jones IRA Robert ABC Bank, Custodian Addr1 Addr2 City State Zip5 Zip4 Account # 123 Anywhere Street America Plaza Hometown AL 12345 6789 12345 123 Anywhere Street America Plaza Hometown AL 12345 6789 12345 124 Anywhere Street America Plaza Hometown AL 12345 6789 12345 123 Anywhere Street America Plaza Hometown AL 12345 6789 12345 123 Anywhere Street America Plaza Hometown AL 12345 6789 12345 456 Overthere Road Bldg 100 Big City NY 98765 4321 44444 456 Overthere Road Bldg 100 Big City NY 98765 4321 44444 456 Overthere Road Bldg 100 Big City NY 98765 4321 44444 15678 Nowhere Boulevard Downtown TN 65432 78945 15678 Nowhere Boulevard Downtown TN 65432 78945 538 Everywhere Uptown FL 000045678 4561 45678 539 Everywhere Uptown FL 000045678 4561 45678 Tax Id # CUSIP Type Security Code Trade Date 123456789 98420A103 B XNL 1/31/2006 123456789 98420A103 P XNL 3/15/2006 123456789 98420A103 P2 XNL 8/10/2006 123456789 98420A103 S XNL 5/25/2006 123456789 98420A103 U XNL 8/16/2006 987654321 98420A103 B XNL 1/31/2006 987654321 98420A103 P XNL 4/29/2006 987654321 98420A103 U XNL 8/16/2006 012345678 98420A103 P XNL 5/16/2006 012345678 98420A103 U XNL 8/16/2006 789456123 98420A103 P XNL 6/6/2006 789456123 98420A103 S XNL 7/25/2006 # of Shares Price/Share Amt Pd or Rec'd. 1000 1500 50 75312.5 600 500 50 24856.22 2600 1 1 90 950 2 10 92.5 93187.25 10 100 50 5156 100 25 2345