FORM No. 11. 
APPLICATION AND ALLOTMENT SHEET. 
Allotment of 100,000 Shares of £10 each in The ¢ A’ Company, Limited, issued at par (or £.... per Share as the case may be). 
SiN 
iN 
ox 
DISTINCTIVE 
Nos. OF SHARES 
Jrom 
w 
3 
O 
pu 
I= 
b 
p= 
— 
> 
— 
0 
= 
> 
a 
$e 
pe, 
O 
ey)