141 Capital Inc (fka ONCP)

[MuchCompensation]

Things that make you say Hmmmm.....

http://www.141capital.com/pdfs/Series%20C%20Preferred%20Stock%20Conversion%20Request.pdf

Series C Preferred Stock Conversion Request

To: 141 Capital, Inc.

1) You are hereby requested to convert
Shares of Series C Preferred Stock into Common Stock, as per 141 Capital’s Amended and Restated Articles of Incorporation. Should the conversion of these shares result in the beneficiary’s holdings exceeding 10% of the issued and outstanding Common Stock of 141 Capital, you are hereby
requested to (clearly indicate one):

a. Adjust the number of Series C Preferred Shares converted such that the total holdings of ONCP Common Stock will not exceed 10% and issue unrestricted Common Stock.

b. Convert the number of Series C Preferred Shares requested and issue restricted Common Stock.

2) The Series C Preferred Share Certificate being converted is Number for
shares. This certificate is (clearly indicate one):

a. Included with this request

b. Held by 141 Capital from a previous request.

3) In the event that the Series C Preferred Shares converted are less than the current value of the certificate, please (clearly indicate one):

a. Hold the remaining Preferred Shares for my account.

b. Forward a new certificate for the remaining Preferred Shares.

4) The Converted Common Shares are to be issued for the benefit of:

Name:
Social Security #:
Address:
For full value received, I hereby sell, assign, and transfer the above disclosed shares.

As of this date, the entity identified in 4 above holds
shares of ONCP Common Stock.
Series C Preferred Shareholder – Signature
Print Name

MAILING INSTRUTIONS: This Series C Preferred Stock Conversion Request, along with the above listed Preferred Certificates, should be mailed to 141 Capital, Inc. at the following address: 29 S. LaSalle St., Suite 333, Chicago, IL 60603.