go

Cet  échange  ne  nécessite  d’autre  formalité  que  la
signature  de  la  formule  suivante  et  le  paiement  des
droits  de  timbre  et  du  droit  prélevé  par  la  Compagnie
pour  l’impression  du  titre.
Voici  la  formule  employée  par  les  De  Beers  Consolidated ­
  Mines,  Ld.  :—
To  the  Directors  of
DE  BEERS  CONSOLIDATED  MINES,  LIMITED,  LONDON.
I,  the  undersigned,  being  the  Hôlder  of,  ,
registered  Shares  of  your  Company,  Nos  the  Certificate

(No  )  whereof  I  enclose,  hereby  request  you  to  issue  to  me  the
following  Share  Warrants  to  Bearer,  in  respect  thereof,  and  I  remit  herewith
£  ,  being  the  fee  of  is.  per  Share  on  conversion.
Share  Warrants,  each  for  ten  Shares.
,  Share  Warrants,  each  for  five  Shares.
Share  Warrants,  each  for  one  Share.

Share  Warrants,  each  for  five  Shares.
Share  Warrants,  each  for  one  Share.

Dated  this

day  of

i9
(Signature.)

Witness

(Name  in  full.)
(Address.)

Directions  as  to  Delivery  of  Share  Warrants.
Please  deliver  the  Share  Warrants  above  referred  to,  when  ready
to
of.  ;
whose  receipt  on  my  behalf  shall  be  a  sufficient  discharge  to  the  Company
for  the  same.
Shareholder's  Signature.

Directions  to  Transmit  the  Share  Warrants  by  Post.
Please  forward  to  me  the  Share  Warrants  referred  to  above,  when
ready,  by  registered  post.

Shareholder's  Signature.