APPENDIX F 
FORM No. 32. 
INDEMNITY AND REQUEST FOR DUPLICATE 
DIVIDEND WARRANT. 
To THE ‘A’ CoMPANY, LIMITED. 
IN consideration of The ‘A’ Company issuing to me a 
duplicate Warrant for the [Interest or Dividend] to the 
[30 June or 31 December, 19....], amounting to fo... co. 
on the [amount of holding, e.g. £100 ordinary stock] registered 
in my name, in lieu of the original Warrant No.....dated........... 
which has been lost, destroyed, or mislaid, I hereby undertake 
and engage for myself, my Executors, Administrators and 
Assigns, to hold the said Company, and the Directors and 
Officers thereof, harmless and indemnified against all losses 
and expenses which may be incurred in the event of the said 
original Warrant being paid or forthcoming at any future 
lime, or otherwise in consequence of the said Company 
issuing a duplicate to me as aforesaid, and I request that 
such duplicate Warrant may be issued to me accordingly 
and I engage to return the original should it be found. 
Dated this........day of... 
rvs Josie 
Stonatur.... 
+“ STH 
nd 
Witness: 
ddrecs ........ 
Signature wr. 
Address... 
EEA uC PIER PRS I PERE BER. OL 
OCCUD ALLOW reese 
Note.—Where there are circumstances involving the slightest suspicion or the amount 
involved is substantial, the holder's bankers should be requested to join in the indemnity.