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SECRETARIAL PRACTICE 
FORM No. 25. 
REQUEST BY EXECUTORS OR ADMINISTRATORS 
TO BE PLACED ON REGISTER IN THEIR OWN 
RIGHT. 
To THE ‘A’ CoMPANY, LIMITED. 
LonpoN WaLL, Lonpon, E.C. 
Name of deceased... wm 
TT 87s swessssssssseasssatace 
Probate. INO...sssmmmssssssssssssssssssssss 
I/We, the undersigned, being the (a)* Executor(s)/rix of the 
*Delete words 
not appropriate. . ] Lo. 
Will, (b) Administrator(s) of the Estate of... i” 
deceased, hereby request you to register me/us as (a) 
member(s) of your Company in respect of the... umm 
Shares numbered... mnt Orme NCIUSIVE [OF Loonies 
Stock], now standing in the name of the said deceased. 
Dated thiS.eed@Y Of cnssssnsssssnsmsssssmsessssssssssmsssssssssssss I Qenensssssne 
Usual signature 
NAME IN FULL cocmmmonmsmsmmmsnsmssmasssssssssssasssssssssssssssssssssases 
AAALEES. crnsimemssisiiiisssisssss mim — 
DESCIIDHION ovvecersoncesssnrssssssssmsssssensasss. 1a senses. o 
Usual signature 
NATE 0 TUL cinnamon: 
AQATESS cesmsecsmsssessasssessissesssssmmmssssssssssasssssssssssssssssssissssssessssass 
Description esr ————— A 
chee astsnOuRIATIeNIRsEIRaNsEeRieensIatesastiestiesnIerrTesIel 
Note.—The Share or Stock Certificates must be lodged at the 
Company's offices with this request, accompanied also by the Probate 
or Administration Letter if not previously lodged. No stamp is 
necessary where the above form is used.