APPENDIX F

FORM No. 10.
APPLICATION FOR SHARES WITH RECEIPT FORM ATTACHED,
Size 13 tn. by 8} in. the scceipl being exactly a quarter of the whole form.
This form is based on the recommendation of the Institute of Bankers, and is designec
for use with ‘ window ’ envelopes.
THE ‘A’ COMPANY, LIMITED.
Registered Office: London Wall, London,
SHARE CAPITAL
Jivided into Snare
[ssux or SHAR'
To the Directors of
THE ‘A’ CompaNY, LIMITED,
Having paid to your Bankers thesumof £_____________ being a deposit of .._ per Share
on Application for. Shares of {__ each in the above-named Company, I/we, being
of full age, hereby request that you will allot to me/us that number of Shares, and I/we here-
by agree to accept the same or any less number that you may allot to me/us upon the terms
and conditions of the Prospectus (dated...) and Memorandum and Articles
of Association of the Company, and I/we authorise you to place my/our name(s) on the
Register of Members in respect of the Shares allotted to me/us.

Name (in full)...
288 ($1,
To be written
distinctly.

" :ston or Business ___________ Soe
womar: should state whether she is a Spinster, Wife or Widow ..
(Date)... o%_
This Form, when duly filled up as directed above, should be sent entire, with the
necessary remittance, to the Company's Bankers, the_ --Bank, Lombard
Street, London, E.C.
Cheques should be made payable to Bearer and crosse

Ce
NEO
¢ RO*
If altered from ‘Order’ to ‘Bearer’ the alteration should be signed by the Drawer.

The Applicant is particularly requested to write clearly, within the bordered space below
his or her name and the full address to which the receipt should be sent. For Joint
Accounts the first name should be written within, and the other or others below the
bordered space.

-e* [PERFORATED **¢*
COMPANY, IMT ~~
““ZCATION F-'C IPT.

Name

of First
or of Sole
Applicant.

REceivED for account of The ‘A’
Company, Limited, from the person(s)
whose name(s) is/are written in the
margin, the undermentioned amount
being a deposit of ___. per share on
Application for Shares in the above:
named Company.

ANh.

mitec

Address

joint
Anplicants

(if any)
Names only.

This Receipt, when returned by
the Bankers, must be preserved by
the Applicant to be exchanged in due
course for the relative Share Certificate.