EX-99.7 11 d385353dex997.htm EX-99.7 EX-99.7

Exhibit 99.7

FORM OF

NOMINEE HOLDER CERTIFICATION

EARGO, INC.

The undersigned, a bank, broker, dealer, trustee, depositary, or other nominee of subscription rights (the “Subscription Rights”) to purchase shares of common stock of Eargo, Inc., a Delaware corporation (the “Company”), pursuant to the Rights Offering described and provided for in the Company’s prospectus dated             , 2022, (the “Prospectus”), hereby certifies to the Company and to Continental Stock Transfer & Trust Company, LLC, as Subscription Agent for such 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 shares pursuant to the oversubscription privilege (as described in the Prospectus), the number of shares specified below, listing separately each such exercised basic subscription privilege and the corresponding oversubscription privilege (without identifying any such beneficial owner), and (2) to the extent a beneficial owner has elected to subscribe for shares pursuant to the oversubscription privilege, each such beneficial owner’s basic subscription privilege has been exercised in full:

 

Individual

Soliciting

   Number of Shares
Owned on the

Record Date
     Individual
Soliciting
Broker (if any)
     Number of
Shares
Subscribed for
Pursuant to the
Basic
Subscription
Privilege
     Number of
Shares
Subscribed for
Pursuant to the
Oversubscription
Privilege
 

1.

           

2.

           

3.

           

4.

           

5.

           

6.

           

7.

           

8.

           

 

 

 

Name of Nominee Holder

 

By:

 

 

 

Name:

 

 

 

Title:

 

 

 

Phone Number:

 

 

 

Fax Number:

 

 

 

Dated:

 

 

 

Provide the following information, if applicable:

 

DTC Participant Number

 

DTC Participant

 

By:

 

 

 

Name:

 

 

 

Title:

 

 

 

 

DTC Bank Subscription Confirmation Number(s)

 

Dated: