Katapult Holdings Inc

For the period ended Aug 6, 2025. Filed Jun 26, 2025.

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Aug 6, 2025 · Filed Jun 26, 2025

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KPLT$11.07+12.1%Stored close · as of Nov 6, 2026

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Contents

ACKNOWLEDGMENT

The Parent Entity hereby acknowledges this Conversion Notice and hereby directs [transfer agent] to issue the above indicated number of shares of Conversion Stock in accordance with the Transfer Agent Instructions dated __________, 202[] from the Parent Entity and acknowledged and agreed to by [transfer agent].

Katapult Holdings, Inc.
By:
	Name:
	Title:

Exhibit L

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