If this form is bound up interleaved for carbon
copy the counterfoil can be dispensed with.

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Left DV ee eecssensesesssssssesemsssenee.
Address

NO. of Shares ....mmmmsssisssscssssene
Amount of Stock £ ween

N AINE OF eee ee eevee oon

NO
THE ‘A’ CoMPANY, LIMITED.
Registered Office; London Wall, London. E.C.
RECEIVED STO coors rermssssssescssesessasssssssasss -sessssssssssacrsa- --snsssssssssssssssssssssasssssssssssssssstn-

ee eas 0A res sRases aNennn E000Re 000000 00INTIatseSsios INANE stettIoNenannssetstedesitinesnend souade
the undermentioned ....o.. Transfer Deed....of... SHARES
[£m SOCK] fOr registration, subject to the approval of the
directors.

No. of Shares,
or
Amount of Stock

Share Numbers

Transferee.

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The Certificate... in respect of the above Transfer... will be
ready for delivery in exchange for this RECEIPt On mmerrsersesssisrin
Fee paid. nssesscessmeeen
Certificate readv.......

Registration Fee nn

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Secyetary