9 8

Date.

Cashier.

B

No.

FORM  OF  RENUNCIATION

Of  rights  by  holder  of  existing  fully  paid  Shares.
(not  to  be  detached.)
To  the  Directors  of
THE  COMPANY,  LIMITED.
I  hereby  renounce  ail  rights  to  which  I  may  be  entitled
in  connection  with  the  above-mentioned  Issue  of  Shares  in  favour  of.

Signature.

Address.

NOT  TO  BE  DETACHED.
BANKERS’  RECEIPT  FOR  PAYMENT  ON  APPLICATION.
IKcceibeCi  this  dayof.  19  ,  froro  the
within-named  Applicant,  for  crédit  of  The
Company,  Limited,  the  sum  of.  :  Pounds,
Shillings,  being  the  amount  payable  on  Application,  on
Shares  in  the  Company.
For  The  Bank,  Limited.

Cashier.

£■

Mémorandum  (to  be  detached  by  Bankers).
THE  COMPANY,  LIMITED.
Issue  of  Shares.
JfUease  ^Eereibc  on  Account  of  Application  No  -
a  &gt;&gt;
The  Bank,  Limited.