Ie

SECRETARIAL PRACTICE
FORM No. 9.
APPLICATION FOR SHARES WHERE NO RECEIPT 1S
ISSUED.
[Size 8} in. by 8% in.]
This form is based on the recommendation of the Institute of Bankers.
THE ‘A’ COMPANY, LIMITED.
Registered Office: London ‘Wall, London.
SHARE CAPITAL f .

Divided into Shares of £ each.
Issue of Shares of :

No.
To the Directors of
Tue ‘A’ CoMPANY, LIMITED.

HavING paid to your Bankers the sum Of fom bEING 2
deposit Of......w.....per Share on Application fOr... .m...3hares of
{own €ach in the above-named Company, I/we, being of full age,
hereby request that you will allot to mejus that number of Shares,
and I/we hereby 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......oomemmenees 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) wren
AQAVESS (110 FULLY ores sss issn sass sss se ees
To be written
distinctly.

Profession OF BUSIHESS. mms wri corstssssissssses
(A woman should state whether she is a Spinster, Wife, or Widow.)
Name (in full) rennin
Address (11 FULD) nensesscssisi
To be written
distinctlv.
Profession oF BUSINESS. erent
. (A woman should state whether she is a Spinster, Wife or Widow.)
(Dated)... wid (Signature)...

This Form, when duly filled up as directed above, should be
sent, with the necessary remittance, to the Company's Bankers,
the ... SE = 1% o 1 : SE ————

Cheaue- ~hould be made pavable to Bearer and crossed

Told Be

tte

Iruwe

bv

‘Order’ to ‘Bearer’ the alteration

et ————
The Company will forward an acknowledgment in due course,
either bv Allotment Letter or bv return of the Deposit.