97

7

No..

FORM  OF  APPLICATION.
To  be  filled  up  and  signed  only  by  the  person  or  persons  in  whose  name
or  names  the  Shares  are  to  be  allotted.

To  the  Directors  of
THE  COMPANY,  LIMITED.
Gentlemen,
Having  paid  to  your  Bankers,  The  Bank,  Ld.,
London,  E.C.,  the  sum  of  £  being  the  amount  payable  upon
application  for  Shares  of  £  each  of  the  above-mentioned
issue,  hereby  request  that  you  will  allot  such  Shares,  and
agréé  to  accept  the  same  upon  the  ternis  and  conditions  under  which
they  are  issued,  and  of  your  Circular  of  the  ,  19
and  of  the  Mémorandum  and  Articles  of  Association  of  the  Company,  and  to
pay  the  further  instalments  (including  premium)  thereon  as  stated  above,  and
request  you  to  place  name  on  the  Register  of  Members  of  the
Company  in  respect  of  the  Shares  so  allotted.

Signature.

Names  in  fit  II...

Date.

Address
Description