CHANTICLEER HOLDINGS, INC.

 

NOMINEE HOLDER CERTIFICATION

 

The undersigned, a broker, custodian bank, trustee, depositary or other nominee holder of subscription rights to purchase units, each unit consisting of one share of our 9% Redeemable Series 1 Preferred Stock and one Series 1 Warrant, in Chanticleer Holdings, Inc. (“Chanticleer”) pursuant to the rights offering described and provided for in the Chanticleer prospectus dated [•], 2016, hereby certifies to Chanticleer, Securities Transfer Corp., as subscription agent for the rights offering, and to Issuer Direct, as information agent for the Rights Offering, that (1) the undersigned has exercised, on behalf of the beneficial owners thereof (which may include the undersigned), the number of subscription rights specified below pursuant to the basic subscription privilege (as described in the prospectus), and on behalf of beneficial owners of subscription rights who have subscribed for the purchase of additional units pursuant to the over-subscription privilege (as described in the prospectus), listing separately below each such exercised basic subscription privilege and the corresponding over-subscription privilege (without identifying any such beneficial owner), and (2) each such beneficial owner’s basic subscription privilege has been exercised in full:

 

Number of Shares of Common Stock and Public Warrants

Owned on the Record Date

  

Rights Exercised Pursuant to Basic

Subscription Privilege

  

Number of Units Subscribed

For Pursuant to

Over-Subscription Privilege
         
1.        
         
2.        
         
3.        
         
4.        
         
5.        
         
6.        
         
7.        
         
8.        
         
9.        

 

Provide the following information if applicable:

 

  
  

 

Depository Trust Company (“DTC”)  

 

Participant Number

 

[PARTICIPANT]

 

By:                      
Name:    
Title:    

 

DTC Basic Subscription Confirmation Number(s)