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SECRETARIAL PRACTICE

FORM No. 35.

AUTHORITY TO PAY INTEREST OR DIVIDENDS.

NOs

To

THE ‘A’ CoMPANY, LIMITED,

London Wall, London, E.C.

For Office use only. .
Noted merrenesssssson
Sh. Reg. Fol. uu.

PLEASE PAY all Dividends, Interest or Bonuses which
[ am now or may be hereafter entitled to receive to the*

0 SONNE RENESAS 8sREEens

AEE Raa are r eer eaENee esa rate ae tere eeIns C0uNNEIIRRREASAARAREREeEeteEatnDssEtIeReentae

Bank at eo

whose acknowledgment shall be a sufficient discharge.

Dated this een. da OF wo

FP1ODYLCLOV’S SUONALUY Coos

AERC R TEER SAW

msddassaaaageansgRanan

881 000ERERRIIININIIEISIIITEIRIN ARISES

Proprietor’s Full Name.........

Permanent Address

ESIGN NA NNN NEEL BENE © i BLABRELELERSI TARSAASANARAARASANAAARASESEEEETSEREEEAEONEes0tsierestesues

* Insert correct description of Bankers with full postal address.
I In Joint Accounts this Form must be signed by all the Registered
Holders.