Exhibit 99(a)(1)(C)

  

 

	Return to: HMS Income Fund, Inc. 430 W. 7th Street Kansas City, Missouri 64105   Hines Investor Relations Toll-Free: 888.220.6121

 

NOTICE OF WITHDRAWAL OF TENDER REGARDING SHARES HELD IN HMS INCOME FUND, INC.

 

COMPLETING AND RETURNING THIS FORM WILL RESCIND YOUR SHARE REPURCHASE REQUEST. PLEASE ONLY COMPLETE AND RETURN THIS FORM IF YOU WISH TO RESCIND YOUR PENDING SHARE REPURCHASE REQUEST FOR THE OFFER DATED NOVEMBER 4, 2016.

 

The undersigned recognizes that upon the receipt on a timely basis of this Notice of Withdrawal of Tender, properly executed, the shares (the “Shares”) of HMS Income Fund, Inc. (the “Company”) previously tendered will not be purchased by the Company.

 

Information

 

Tendered pursuant to the Offer to Purchase dated November 4, 2016.

 

The offer and withdrawal rights will expire at, and this Notice of Withdrawal must be received by the Company either by hand-delivery, mail or facsimile before 5:00 P.M., Central Time, on December 16, 2016, unless the offer is extended.

 

COMPLETE THIS NOTICE OF WITHDRAWAL AND RETURN TO THE FOLLOWING ADDRESS:

 

HMS Income Fund, Inc.

430 W. 7th Street

Kansas City, Missouri 64105

Phone: 888.220.6121

Fax: 713.966.2661

 

You are responsible for confirming that this Notice of Withdrawal is received by the Company at the address above.

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One	Investor Information
Print name(s) as registered on the account.	Name(s) On the Account
	HMS Account Number	Social Security Number or TIN on Account
	Financial Advisor Name and Phone Number
Two	Withdrawal Request
The undersigned hereby withdraws the tender of its Shares to the Company for purchase by the Company that previously was submitted by the undersigned in a Letter of Transmittal dated _________________________ , 2016.   This tender was in the amount of: o All Shares as of the Expiration Date, or o _____________ Number of Shares.   The undersigned recognizes that upon the receipt on a timely basis of this Notice of Withdrawal of Tender, properly executed, the Shares previously tendered will not be purchased by the Company.
Three	Authorized Signatures
Sign exactly as your account is registered	Investor Name (Please Print)                             Signature                             Date
	Investor Name (Please Print)                             Signature                             Date