INFOCURE CORP
DEF 14A, 1999-02-01
PREPACKAGED SOFTWARE
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<PAGE>
 
                                UNITED STATES
                      SECURITIES AND EXCHANGE COMMISSION
                            WASHINGTON, D.C. 20549

                           SCHEDULE 14A INFORMATION

          Proxy Statement Pursuant to Section 14(a) of the Securities
                  Exchange Act of 1934 (Amendment No.      )
        
Filed by the Registrant [X]

Filed by a Party other than the Registrant [_] 

Check the appropriate box:

[_]  Preliminary Proxy Statement         [_]  CONFIDENTIAL, FOR USE OF THE
                                              COMMISSION ONLY (AS PERMITTED BY
                                              RULE 14A-6(E)(2))

[X]  Definitive Proxy Statement 

[_]  Definitive Additional Materials 

[_]  Soliciting Material Pursuant to Section 240.14a-11(c) or Section 240.14a-12

                             INFOCURE CORPORATION
- --------------------------------------------------------------------------------
               (Name of Registrant as Specified In Its Charter)


- --------------------------------------------------------------------------------
   (Name of Person(s) Filing Proxy Statement, if other than the Registrant)

   
Payment of Filing Fee (Check the appropriate box):

[X]  No fee required

[_]  Fee computed on table below per Exchange Act Rules 14a-6(i)(4) and 0-11.

   
     (1) Title of each class of securities to which transaction applies:

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     (2) Aggregate number of securities to which transaction applies:

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     (3) Per unit price or other underlying value of transaction computed
         pursuant to Exchange Act Rule 0-11 (Set forth the amount on which
         the filing fee is calculated and state how it was determined):

     -------------------------------------------------------------------------
      

     (4) Proposed maximum aggregate value of transaction:

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     (5) Total fee paid:

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[_]  Fee paid previously with preliminary materials.
     
[_]  Check box if any part of the fee is offset as provided by Exchange
     Act Rule 0-11(a)(2) and identify the filing for which the offsetting fee
     was paid previously. Identify the previous filing by registration statement
     number, or the Form or Schedule and the date of its filing.
     
     (1) Amount Previously Paid:
 
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     (2) Form, Schedule or Registration Statement No.:

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     (3) Filing Party:
      
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     (4) Date Filed:

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<PAGE>
 
                             INFOCURE CORPORATION
                               1765 The Exchange
                                   Suite 450
                            Atlanta, Georgia 30339
 
                               ----------------
 
                   NOTICE OF SPECIAL MEETING OF STOCKHOLDERS
                          To Be Held on March 3, 1999
 
                               ----------------
 
TO THE STOCKHOLDERS OF INFOCURE CORPORATION:
 
  Notice is hereby given that a Special Meeting of Stockholders of InfoCure
Corporation will be held on Wednesday, March 3, 1999 at 10:00 a.m. local time,
at the offices of InfoCure, 1765 The Exchange, Suite 450, Atlanta, Georgia, to
consider and act upon the following matters:
 
  1. To approve an amendment to InfoCure's certificate of incorporation to
     increase the number of authorized shares of common stock, par value
     $.001 per share, from 15,000,000 shares to 200,000,000 shares.
 
  2. To transact such other business as may properly come before the meeting
     or any adjournment of the meeting.
 
  Stockholders of record at the close of business on February 1, 1999 will be
entitled to notice of and to vote at the meeting or any adjournment thereof.
 
  All stockholders are cordially invited to attend the meeting.
 
                                          By Order of the Board of Directors,
 
                                          James K. Price
                                          Executive Vice President and
                                           Secretary
 
February 1, 1999
Atlanta, Georgia
 
WHETHER OR NOT YOU EXPECT TO ATTEND THE MEETING, PLEASE COMPLETE, DATE AND
SIGN THE ENCLOSED PROXY AND MAIL IT PROMPTLY IN THE ENCLOSED ENVELOPE OR
FOLLOW INSTRUCTIONS ON THE PROXY TO VOTE OVER THE TELEPHONE IN ORDER TO ASSURE
YOUR REPRESENTATION AT THE MEETING. NO POSTAGE NEED BE AFFIXED IF MAILED IN
THE UNITED STATES. IN THE EVENT YOU ARE ABLE TO ATTEND THE MEETING, YOU MAY
REVOKE YOUR PROXY AND VOTE YOUR SHARES IN PERSON. PLEASE NOTE, HOWEVER, THAT
IF YOUR SHARES ARE HELD OF RECORD BY A BROKER, BANK OR OTHER NOMINEE AND YOU
WISH TO VOTE AT THE MEETING, YOU MUST OBTAIN FROM THE RECORD OWNER A PROXY IN
YOUR NAME.
<PAGE>
 
                             INFOCURE CORPORATION
                               1765 The Exchange
                                   Suite 450
                            Atlanta, Georgia 30339
 
                               ----------------
              PROXY STATEMENT FOR SPECIAL MEETING OF STOCKHOLDERS
                          To Be Held on March 3, 1999
                               ----------------
 
General
 
  This Proxy Statement and the enclosed proxy are furnished on behalf of the
Board of Directors of InfoCure Corporation, a Delaware corporation, for use at
a Special Meeting of Stockholders to be held on March 3, 1999 at 10:00 a.m.
local time (the "Special Meeting") or at any adjournment or postponement of
that meeting, for the purposes set forth herein and in the accompanying Notice
of Special Meeting. The Special Meeting will be held at the offices of
InfoCure, 1765 The Exchange, Suite 450, Atlanta, Georgia. InfoCure intends to
mail this Proxy Statement and the accompanying proxy card on or about February
1, 1999 to all stockholders entitled to vote at the Special Meeting. All
proxies will be voted in accordance with the stockholder's instructions
indicated by the selection set forth on the proxy card. If a stockholder does
not select a choice, the proxy will be voted in favor of the proposals set
forth in the accompanying Notice of Meeting. Any proxy may be revoked by a
stockholder at any time before it is exercised by giving written notice to
that effect to the Secretary of InfoCure.
 
  As used in this Proxy Statement, the term "InfoCure" refers to InfoCure
Corporation and its subsidiaries, unless the context otherwise requires.
 
Stockholders Entitled to Vote
 
  The Board of Directors has fixed February 1, 1999 as the record date for
determining stockholders who are entitled to vote at the meeting. At the close
of business on February 1, 1999, there were outstanding and entitled to vote
7,545,354 shares of common stock of InfoCure, par value $.001 per share and
850,060 shares of Convertible, Redeemable Preferred Stock, Series A, par value
$.001 per share (the "Series A Preferred"). Each stockholder of record on such
date will have one vote for each share of common stock and 1.18 votes for each
share of Series A Preferred.
 
  Holders of common stock have 88% of the general voting power; holders of
Series A Preferred have the remaining 12% of the general voting power. Holders
of common stock and holders of Series A Preferred will vote together on the
matters to be voted upon at the Special Meeting.
 
  The holders of one-third of the total shares of common stock and Series A
Preferred entitled to vote on the record date, whether present at the Special
Meeting, or represented by proxy, will constitute a quorum for the transaction
of business at the Special Meeting. The shares held by each stockholder who
(i) signs and returns the enclosed form of proxy or (ii) submits a proxy over
the telephone according to the enclosed instructions will be counted for the
purposes of determining the presence of a quorum at the Special Meeting,
whether or not the stockholder abstains on the matter to be acted on at the
Special Meeting. Broker non-votes will also be counted toward fulfillment of
quorum requirements. A broker non-vote occurs when a nominee holding shares
for a beneficial owner does not vote on a particular proposal because the
nominee does not have discretionary voting power with respect to that proposal
and has not received instructions from the beneficial owner.
<PAGE>
 
Solicitation
 
  InfoCure will bear the entire cost of solicitation of proxies, including
preparation, assembly, printing and mailing of this Proxy Statement and the
accompanying proxy card. Copies of solicitation materials will be furnished to
banks, brokerage houses, fiduciaries and custodians holding in their names
shares of common stock beneficially owned by others to forward to such
beneficial owners. InfoCure may reimburse persons representing beneficial
owners of common stock for their costs of forwarding solicitation materials to
such beneficial owners.
 
          STOCK OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT
 
  The following table sets forth, as of February 1, 1999, the beneficial
ownership of InfoCure's outstanding common stock and preferred stock of: (i)
each person known by InfoCure to own beneficially more than 5% of InfoCure's
outstanding common stock or preferred stock; (ii) the Chief Executive Officer
and the next four most highly compensated executive officers of InfoCure in
1998; (iii) each director of InfoCure; and (iv) all executive officers and
directors as a group:
 
<TABLE>
<CAPTION>
                               Common Stock             Preferred Stock
                          Beneficially Owned(1)      Beneficially Owned(1)
                          -------------------------  -------------------------
                          Number of                  Number of
                          Shares of                  Shares of
    Name and Address        Common      Percentage   Preferred     Percentage
  of Beneficial Owners      Stock        of Class      Stock        of Class
  --------------------    ------------- -----------  ------------  -----------
<S>                       <C>           <C>          <C>           <C>
Norson's International
 LLC(2).................        385,027         5.1%           --           --
William Herbert Hunt
 Trust Estate(3)........        548,932         7.0        268,440         31.6%
Crescent International
 Limited(4).............        431,322         5.7            --           --
Frederick L. Fine(5)....        510,218         6.7            --           --
James K. Price(6).......        510,300         6.7            --           --
Richard E. Perlman(7)...        337,055         4.4            --           --
Michael E. Warren(8)....         84,192         1.1            --           --
James D. Elliott(9).....         28,886           *            --           --
Raymond H. Welsh........         18,000           *            --           --
R. Ernest Chastain(10)..         56,569           *            --           --
Donald M. Rogers(11)....         91,828         1.2            --           --
All executive officers
 and directors as a
 group
 (11 persons)(12).......      1,749,828        22.3%           --           --
</TABLE>
- --------
 *  Less than one percent.
 (1) Information with respect to "beneficial ownership" shown in the table
     above is based on information supplied by the respective beneficial owner
     or by other stockholders as well as filings made with the Securities and
     Exchange Commission (the "Commission") or furnished to InfoCure.
     Beneficial ownership is determined in accordance with the rules of the
     Commission and generally includes voting or investment power with respect
     to securities. For purposes of calculating the percentage beneficially
     owned, the shares of common stock deemed outstanding include: (i)
     7,545,354 shares of common stock outstanding as of February 1, 1999; (ii)
     the conversion of the 850,060 shares of Series A Preferred into 1,000,070
     shares of common stock; and (iii) shares issuable by InfoCure pursuant to
     options held by the respective person or group which may be exercised
     within 60 days following the date of this Proxy Statement ("Presently
     Exercisable Options"). Presently Exercisable Options are deemed to be
     outstanding and to be beneficially owned by the person or group holding
     such options for the purpose of computing the percentage ownership of
     such person or group but are not treated as outstanding for the purpose
     of computing the percentage ownership of any other person or group.
     Unless otherwise specified, the mailing address of each beneficial owner
     is c/o InfoCure Corporation, 1765 The Exchange, Suite 450, Atlanta,
     Georgia 30339.
 (2) According to a Schedule 13G filed by Norson's International, LLC
     ("Norson's") dated August 9, 1997 and other information provided by
     Norson's, Norson's has sole voting and dispositive power as to the
 
                                       2
<PAGE>
 
    shares of common stock. The mailing address of Norson's is 1411 Rouse
    Lane, Suite 201, Roswell, Georgia 30076.
 (3) According to a Schedule 13D filed by The William Herbert Hunt Trust
     Estate (the "Hunt Trust") dated February 19, 1998, the Hunt Trust has
     sole voting and dispositive power as to the shares of common stock. The
     common stock total includes 315,811 shares of common stock issuable upon
     conversion of 268,440 shares of Series A Preferred at a conversion price
     of $8.50 per share. The mailing address of the Hunt Trust is 3900
     Thanksgiving Tower, 1601 Elm Street, Dallas, Texas 75201.
 (4) According to a Schedule 13D filed by Crescent International Limited
     ("Crescent") dated December 21, 1998, Crescent has sole voting and
     dispositive power as to the shares of common stock. Crescent's mailing
     address is c/o Greenlight (Switzerland) SA, 84, Av Louis-Casai, P.O. Box
     42, 1216, Geneva, Cointrin, Switzerland.
 (5) Includes 3,579 shares held by Mr. Fine for the benefit of his children
     and 1,193 shares held by a charitable trust over which he has sole voting
     and investment control. Also includes 48,424 shares issuable upon the
     exercise of Presently Exercisable Options.
 (6) Includes 3,225 shares held by Mr. Price's brother as to which Mr. Price
     maintains voting control. Also includes 48,424 shares issuable upon the
     exercise of Presently Exercisable Options.
 (7) Includes (i) 195,691 shares held by Compass Partners, L.L.C. ("Compass"),
     of which Mr. Perlman holds a majority interest; (ii) 110,000 shares
     issuable to Compass upon exercise of an outstanding warrant at an
     exercise price of $5.50 per share; and (iii) 47,364 shares issuable upon
     the exercise of Presently Exercisable Options.
 (8) Includes 34,330 shares issuable upon the exercise of Presently
     Exercisable Options.
 (9) Includes 5,000 shares issuable upon the exercise of Presently Exercisable
     Options.
(10) Includes 55,271 shares issuable upon the exercise of Presently
     Exercisable Options.
(11) Includes 40,511 shares held by Mr. Rogers' spouse. Also includes 10,000
     shares issuable upon the exercise of Presently Exercisable Options.
(12) Includes an aggregate of 272,137 additional shares issuable upon the
     exercise of Presently Exercisable Options.
 
Revocability of Proxies
 
  Any person giving a proxy pursuant to this solicitation has the power to
revoke it at any time before it is voted by giving written notice of
revocation or a duly executed proxy bearing a later date to the Secretary of
InfoCure, or by attending the meeting and voting in person. Attendance at the
meeting will not, by itself, revoke a proxy.
 
Counting of Votes
 
  The affirmative vote of the holders of a majority of the voting power of the
outstanding shares of InfoCure is required for the approval the proposed
amendment to InfoCure's certificate of incorporation which is to be submitted
to the stockholders at the Special Meeting. Each proxy will be voted in
accordance with the stockholder's directions. Abstentions with respect to any
matter to be voted upon at the Special Meeting will have the same effect as a
vote against the proposal. When the enclosed proxy is properly signed and
returned, or when the stockholder submits a proxy over the telephone, the
shares which the proxy represents will be voted at the Special Meeting in
accordance with the instructions of the stockholder. In the absence of such
instructions, the shares represented by a signed or telephonically verified
proxy will be voted in favor of the proposal. All votes will be tabulated by
the inspector of election appointed for the meeting, who will separately
tabulate affirmative and negative notes, abstentions and broker non-votes.
 
                                       3
<PAGE>
 
              PROPOSED AMENDMENT TO INCREASE THE NUMBER OF SHARES
               OF COMMON STOCK WHICH INFOCURE HAS THE AUTHORITY
             TO ISSUE FROM 15,000,000 SHARES TO 200,000,000 SHARES
 
Introduction
 
  On January 13, 1999, the Board of Directors adopted an amendment to
InfoCure's certificate of incorporation, as amended, subject to approval by
the stockholders, to increase the number of authorized shares of common stock
from 15,000,000 shares to 200,000,000 shares (the "Amendment"). The Board of
Directors also directed that the Amendment be submitted for action at the
Special Meeting of Stockholders to be held on March 3, 1999.
 
Increase in Number of Shares of Common Stock
 
  InfoCure's certificate of incorporation currently authorizes the issuance of
a total of 17,000,000 shares, consisting of 15,000,000 shares of common stock,
par value $.001 per share, and 2,000,000 shares of preferred stock, par value
$.001 per share. The Amendment will increase the total number of authorized
shares to 202,000,000, and the number of shares of common stock authorized to
200,000,000. The Amendment will modify the certificate of incorporation to
provide as follows:
 
  "FOURTH: The aggregate number of shares of all classes of the capital stock
  which the corporation shall have authority to issue is two hundred two
  million (202,000,000) shares which are divided into two million (2,000,000)
  shares of preferred stock with a par value of $.001 each, and two hundred
  million (200,000,000) shares of common stock with a par value of $.001
  each."
 
  The Amendment will not change the currently authorized number of shares of
preferred stock, which will remain set at 2,000,000. 850,060 shares of Series
A Preferred have been issued and are outstanding as of February 1, 1999.
 
  As of February 1, 1999:
 
  .  7,545,354 shares of common stock are issued and outstanding;
 
  .  4,636,395 shares of common stock have been reserved for issuance under
     InfoCure's stock option and stock purchase plans;
 
  .  1,000,070 shares of common stock have been reserved for issuance upon
     conversion of the outstanding Series A Preferred stock; and
 
  .  955,382 shares of common stock have been reserved for issuance in
     connection with outstanding warrants and convertible notes.
 
Accordingly, InfoCure may not issue more than 822,489 additional shares of
common stock without the authorization from the stockholders to amend
InfoCure's certificate of incorporation to increase in the number of
authorized shares of common stock. The additional shares of common stock for
which authorization is sought would be identical to the shares of common stock
now authorized. Adoption of the Amendment and the issuance of newly authorized
common stock would not affect the rights of holders of currently outstanding
common stock, except for effects incidental to increasing the number of shares
of common stock outstanding. Holders of common stock do not have preemptive
rights to subscribe to additional securities that may be issued by InfoCure,
which means that current stockholders do not have a prior right to purchase
any new issue of capital stock of InfoCure in order to maintain their
proportionate ownership thereof. If the Amendment is adopted, it will become
effective upon the filing of the proposed amendment with the Delaware
Secretary of State.
 
Appraisal Rights in Respect of the Proposed Amendment
 
  Under the applicable provisions of the Delaware General Corporation Law,
InfoCure's stockholders have no rights to dissent from, or obtain payment of
the fair value of their shares in the event of the approval of, the proposed
Amendment.
 
                                       4
<PAGE>
 
Recommendation of the Board of Directors
 
  The Board of Directors has approved and recommends to the stockholders the
adoption of the Amendment in order to provide authorized shares that may be
used by InfoCure to:
 
  .  continue InfoCure's strategy of growth through acquisition of targeted
     companies;
 
  .  allow an increase in the number of shares reserved for issuance pursuant
     to InfoCure's stock option and stock purchase plans;
 
  .  provide a source of shares to issue in future public or private
     offerings of InfoCure's common stock; and
 
  .  meet other corporate objectives which the Board of Directors believes
     are advantageous to InfoCure and its stockholders.
 
  InfoCure's business model is based on continued growth by InfoCure. InfoCure
expects to achieve this growth in part through strategic acquisitions. Since
the authorized number of shares of common stock was set at 15,000,000,
InfoCure has acquired nine practice management systems vendors. In many of
these acquisitions, all or part of the purchase price was paid with shares of
common stock. The Board of Directors of InfoCure believes it is in the best
interest of InfoCure's stockholders to authorize additional shares of common
stock so that those shares will be available to issue as consideration for
future acquisitions.
 
  Effective as of October 23, 1998, the Board of Directors approved:
 
  .  an amendment to InfoCure's 1996 Stock Option Plan to increase the number
     of shares of common stock reserved for issuance pursuant to such plan
     from 1,250,000 shares to 3,000,000 shares;
 
  .  an amendment to InfoCure's Length-of-Service Nonqualified Stock Option
     Plan to increase the number of shares of common stock reserved for
     issuance pursuant to such plan from 150,000 shares to 500,000 shares;
     and
 
  .  an amendment to InfoCure's Employee Stock Purchase Plan to increase the
     number of shares of common stock reserved for issuance pursuant to such
     plan from 100,000 shares to 150,000 shares, in each case subject to
     receipt of stockholder approval.
 
An increase in the authorized common stock may be necessary to permit any
future increase in the number of shares reserved for issuance pursuant to
these plans. The Board of Directors believes that it is in the best interest
of InfoCure and its stockholders that InfoCure have the ability to continue to
grant stock options and stock purchase rights to its employees and directors
in order to motivate high levels of performance for InfoCure and to attract
and retain highly qualified technical and other key personnel. As InfoCure
grows, InfoCure believes that it is important to grant stock options to its
new employees including those working for acquired companies. The Board of
Directors believes that it is in the best interest of InfoCure to have shares
in the event that it is deemed necessary in the future to increase the number
of shares available under its stock option and stock purchase plans.
 
  In the past, InfoCure has issued shares in private and public financings to
provide capital for its growth. InfoCure believes its capital needs will
require it to pursue additional financings, including an underwritten public
offering of shares of its common stock, in the near future. If a public or
private offering is consummated, InfoCure intends to use the net proceeds of
that offering to repay debt obligations and provide working capital. The Board
of Directors believes a public offering would be in the best interest of
InfoCure and its stockholders. InfoCure will not be able to complete a public
offering of shares of common stock as currently contemplated by the Board of
Directors without stockholder approval of the increase of the number of
authorized but unissued shares of common stock.
 
  Adoption of the Amendment would also provide additional authorized shares of
common stock that could be used from time to time, without further action or
authorization by the stockholders (except as may be required by law or the
rules of the Nasdaq Stock Market or other stock exchange on which InfoCure's
securities may
 
                                       5
<PAGE>
 
then be listed) for other corporate purposes which the Board may deem
desirable, including, without limitation, stock splits, stock dividends or
other distributions, financings, stock grants, stock options, employee benefit
plans and stockholders' rights plans. In the event stockholder approval of the
Amendment is obtained, InfoCure would have a total of approximately 192.4
million shares of authorized but unissued shares of common stock remaining
available pursuant to its certificate of incorporation, of which approximately
6.6 million shares would be reserved for issuance under stock option plans,
warrants, convertible notes and convertible preferred stock. InfoCure's Board
of Directors believes that it is advisable and in InfoCure's best interest to
authorize the additional shares of common stock discussed in this proposal.
 
  THE BOARD OF DIRECTORS RECOMMENDS A VOTE "FOR" THE PROPOSED AMENDMENT.
 
               DEADLINE FOR SUBMISSION OF STOCKHOLDER PROPOSALS
 
  InfoCure's next Annual Meeting will be held in May 1999. The deadline for
stockholders to submit one or more proposals to be presented at the 1999
Annual Meeting expired on December 30, 1998.
 
                                 OTHER MATTERS
 
  Management knows of no other matters which may properly be and are likely to
be brought before the meeting, other than the matter discussed herein.
However, if any other matters properly come before the meeting, the persons
named in the enclosed proxy will vote in accordance with their best judgment.
 
                                VOTING PROXIES
 
  The Board of Directors recommends an affirmative vote on the proposal
specified. Proxies will be voted as specified. If signed proxies are returned
without specifying an affirmative or negative vote on any proposal, the shares
represented by such proxies will be voted in favor of the Board of Directors'
recommendation.
 
                                          BY ORDER OF THE BOARD OF DIRECTORS
 
                                          /s/ Frederick L. Fine
 
                                          Frederick L. Fine
                                          President and Chief Executive
                                          Officer
 
February 1, 1999
 
 
                                       6
<PAGE>
 
                              INFOCURE CORPORATION

                         SPECIAL MEETING OF STOCKHOLDERS

                                  March 3, 1999

P    The undersigned hereby appoints Frederick L. Fine and James K. Price, and
     each of them, with power of substitution, proxies to represent and to vote
R    all shares of common stock or Series A Preferred of InfoCure Corporation,
     which the undersigned is entitled to vote, at the Special Meeting of
O    Stockholders to be held in Atlanta, Georgia on Wednesday, March 3, 1999, at
     10 A.M., EST, and at any and all adjournments thereof, and hereby
X    revokes any prior proxies given with respect to such stock, and the
     undersigned authorizes the voting of such stock as follows on the reverse
Y    side.

- --------------------------------------------------------------------------------
HAS YOUR ADDRESS CHANGED:                        DO YOU HAVE COMMENTS?


- ------------------------------                   -------------------------------

- ------------------------------                   -------------------------------

- ------------------------------                   -------------------------------

                   CONTINUED AND TO BE SIGNED ON REVERSE SIDE
                              --------------------
                                   SEE REVERSE     
                                      SIDE         
                              --------------------
<PAGE>
 
[X]    PLEASE MARK YOUR VOTES
       AS THIS EXAMPLE


                                                  FOR      AGAINST     ABSTAIN 
1. To consider and act upon a proposal to         [__]      [__]        [__]   
   approve an amendment to InfoCure's        
   certificate of incorporation to increase
   the number of authorized shares of
   common stock par value $.001 per share,
   from 15,000,000 shares to 200,000,000
   shares.

THE BOARD OF DIRECTORS RECOMMENDS A VOTE "FOR" PROPOSAL 1.


2. In their discretion, the proxies are authorized to vote upon such business as
   may properly come before the meeting.


I plan to attend the meeting.  [__]   I do not plan to attend the meeting.  [__]

Change of address/comments on reverse side.  [__]

SIGNATURE(S)
            ---------------------------------------------
DATE 
    -----------------------------------

NOTE: Please sign exactly as name appears hereon.
      Joint owners should each sign.
      When signing as attorney, executor, administrator, trustee or guardian,
      please give full title as such.


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