e-dividend mandate activation form · nulec industries plc okomu oil palm plc premier paint plc...

Africa Prudential Registrars Plc @APRPlc

INSTRUCTIONPlease complete all section of this form to make it eligible for processing and return to theaddress below.

The RegistrarAfrica Prudential Registrars Plc220B, Ikorodu Road, Palmgrove, Lagos.

E-DIVIDEND MANDATE ACTIVATION FORM

Bank Verification Number (BVN):

DISCLAIMER"In no event shall Africa Prudential Registrars be liable for any damages , losses or liabilities including without limitation, direct or indirect,special, incidental, consequential damages, losses or liabilities, in connection with your use of this form or your inability to use theinformation, materials, or in connection with any failure, error, omission, defect, delay in operation or transmission, or system failure,even if you advice us of the possibility of such damages, losses of expenses, whether express or implied in respect of such information."

AffixCurrentPassport

Write your name at the back of

your passport photograph

(to be stamped by your banker)

I/We hereby request that henceforth, all my/our Dividend Payment(s) due to me\us frommy/our holdings in all the companies ticked at the right hand column be credited directly tomy /our bank detailed below:

Bank Name:

Bank Account Number:

Account Opening Date: D D M M Y Y Y Y

SHAREHOLDER ACCOUNT INFORMATION

Surname/Company’s Name First Name Other Name

Address

City State Country

Previous Address (if any)

Clearing House Number (CHN) (if any) Name of Stockbroking Firm

C

Mobile Telephone 1 Mobile Telephone 2

E-mail Address

Signature:Joint/Company’s Signatories

Signature:

Company Seal (if applicable)

ONLY CLEARING BANKS ARE ACCEPTABLE

1. AFRICA PRUDENTIAL REGISTRARS PLC

2. ABBEY MORTGAGE BANK PLC

3. AFRILAND PROPERTIES PLC

4. A & G INSURANCE PLC

5. MIXTA REAL ESTATE PLC (formerlyARM Properties Plc)

6. A.R.M LIFE PLC

7. ADAMAWA STATE GOVERNMENT BOND

8. BECO PETROLEUM PRODUCTS PLC

9. BUA GROUP

10. BENUE STATE GOVERNMENT BOND

11. CAP PLC

12. CAPPA AND D'ALBERTO PLC

13. CEMENT COY OF NORTHERN NIG. PLC

14. CSCS PLC

15. CHAMPION BREWERIES PLC

16. COMPUTER WAREHOUSE GROUP

17. EBONYI STATE GOVERNMENT BOND

18. GOLDEN CAPITAL PLC

19. INFINITY TRUST MORTGAGE BANK PLC

20. INTERNATIONAL BREWERIES PLC

21. INVESTMENT & ALLIED ASSURANCE PLC

22. JAIZ BANK PLC

23. KADUNA STATE GOVERNMENT BOND

24. NEM INSURANCE PLC

25. NEXANS KABLEMETAL NIG. PLC

26. OMOLUABI SAVINGS AND LOANS PLC

27. PERSONAL TRUST & SAVINGS LTD

28. P.S MANDRIDES PLC

29. PORTLAND PAINTS & PRODUCTS NIG. PLC

30. PREMIER BREWERIES PLC

31. RESORT SAVINGS & LOANS PLC

32. ROADS NIGERIA PLC

33. SCOA NIGERIA PLC

34. TRANSCORP HOTELS PLC

35. TRANSCORP PLC

36. TOWER BOND

37. THE LA CASERA CORPORATE BOND

38. UACN Plc

39. UBA BALANCED FUND

40. UBA BOND FUND

41. UBA CAPITAL PLC

42. UBA EQUITY FUND

43. UBA MONEY MARKET FUND

44. UNITED BANK FOR AFRICA PLC

45. UNIC PLC

46. UAC PROPERTY DEVELOPMENT COMPANY PLC

47. UTC NIGERIA PLC

48. WEST AFRICAN GLASS IND PLC

CLIENTELE A/C No.

Affix Current Passport

(To be stamped by Bankers)

Write your name at the back of your passport photograph


TICK NAME OF COMPANY

SHAREHOLDER’S ACCOUNT NO.

Instruction Only Clearing Banks are acceptable Please complete all section of this form to make it eligible for processing and return to the address below The Registrar, ALL CROWN REGISTRARS LIMITED 190, Ikorodu Road, Onipanu, Shomolu, Lagos. I\We hereby request that henceforth, all my\our Dividend Payment(s) due to me\us from my\our holdings in all the companies ticked at the right hand column be credited directly to my \ our bank detailed below:

Bank Verification Number

Bank Name

Bank Account Number

Account Opening Date

Shareholder Account Information

Surname / Company’s Name First Name Other Names

Address :

City

Previous Address (If any)

CHN (If any)

State Country


Email Address

Signature(s) Company Seal (If applicable)

Joint\Company’s Signatories

Help Desk Telephone No/Contact Centre Information for Issue resolution or clarification: 234-08023428713

ALL CROWN REGISTRARS LIMITED website:www.allcrownregistrarltd.com; E-mail: [email protected]

BOC GASES NIGERIA PLC

GREIF NIGERIA PLC

NAME OF COMPANYACORN PET. PLCAFRIK PHARMACEUTICALS PLCAG HOMES SAVINGS & LOANSAG LEVENTISARBICO PLCASHAKACEM PLCBANKERS WAREHOUSEBETA GLASSCAPITAL HOTEL PLCELLAH LAKESEVANS MED PLCFCMB BONDFCMB GROUP PLCFIDSON BONDG. CAPPA PLCGUINEA PLCIMB ENERGY MASTER FUNDJOS INT. BREWERIES PLCKOGI SAVINGS & LOAN LTDLAFARGE AFRICA PLCLAFARGE BONDLAW UNION & ROCK PLCLEGACY FUNDLIVESTOCK FEEDS PLCMORISON PLCMRS OIL PLCNAHCO BONDNAHCO PLCNEWPAK PLCN.G.C PLCNGC STERILENPF MICROFINANCE BANKNULEC INDUSTRIES PLCOKOMU OIL PALM PLCPREMIER PAINT PLCREAN PLCSKYE BANK PLCTOTAL NIG. PLCTRANEX PLCWOMEN INVESTMENT FUND

TICK ACCOUNT NO.SHAREHOLDER’S


Instructions

Please complete all section of this form to make it eligible for processing and return to the address below The Registrar Centurion Registrars 33C, Cameron Road, Ikoyi, Lagos Lagos State I\We hereby request that henceforth, all my\our Dividend Payment(s) due to me\us from my\our holdings in all the companies ticked at the right hand column be credited directly to my \ our bank detailed below:


TICK NAME OF COMPANY SHAREHOLDER A/C NO.

DIAMOND BANK PLC

C & I LEASING PLC

LINKAGE ASSURANCE PLC

NIGERIA WIRE INDUSTRIES PLC

UNION DICON SALT PLC

VITAL PRODUCTS LIMITED

Only Clearing Banks are acceptable


Bank Name Bank Account Number


SURNAME FIRSTNAME

OTHERNAMES

ADDRESS

CITY STATE COUNTRY

PREVIOUS ADDRESS (IF ANY)

CHN (IF ANY)

MOBILE TELEPHONE 1 MOBILE TELEPHONE 2

EMAIL ADDRESS

SIGNATURE COMPANY SEAL (IF ANY)

JOINT\COMPANY’S SIGNATORIES

Affix

Current Passport

(To be stamped by

Bankers)

Write your name at the

back of your passport

photograph

Help Desk: customercare.centurionregistrars.com

Tel no: +234-01-2902996, 4663631, 4543311, 07045355922

web: www.centurionregistrars.com // e-mail: [email protected]

mailto:[email protected]


Please complete all sections of this form to make it eligible for processing and return to the address below

The Registrar,

Bank Name


Address:

City


CHN (If any)

State Country


Email Address

Signature(s)


Website: www.unitedsecuritieslimited.com ; E -mail: [email protected] or the completed update form can also be submitted through any Access Bank PLC nearest to you.

ansmitted electronically”

Kindly tick & quote your shareholder account no in the box below

Tick Name of Company Shareholder Number



Bank Account Number

Instruction

E-MANDATE ACTIVATION FORM

Affix Current Passport (To be stamped by bankers) Please write your name at the back of your passport photograph


Website:

2C, Gbagada Expressway, By Beko Ransome Kuti Park, Anthony Oke Bus Stop, Gbagada,P.M.B 10014, Shomolu, Lagos State.

DataMax Registrars Limited

AXA Mansard Insurance Plc.

Guaranty Trust Bank Plc.

Imperial Mortgage Bank Limited

IFC - Naija Bond

Kogi State Bond

Mainstream Energy Solutions

Seplat Petroleum Development Plc.

Sterling Assurance (Sterling Trust Fund).

Help desk , Telephone No. 01-712000-11, 0700DATAMAX or send e-mail to [email protected]

DATAMAX REGISTRARS LIMITED www.datamaxregistrars.com; E-Mail: [email protected] or the completed form can be submitted through any GTBank nearest to you.

• • DataMax Registrars Limited hereby disclaims liability or responsibility for any errors/omissions in any document transmitted electronically.

.

Company Seal/ Incorporation Number (Corporate Shareholder)

When completed on behalf of corporate body, each signatory should state the representative capacity e.g. Company Secretary, Directors etc.

* Please ensure that the name on your Bank Account corresponds with

your request.

that in our records as any contrary Name(s) would void your request

** The signature(s) must correspond with your specimen held in our

s would void your records as any contrary signature(s) or non-existence in our recordswould void your request.

s) in item 4

which I/we become entitled for the company indicated, to the branch of the Bank I/ We hereby request that you forward until further notice, all future dividend/ interest to

named below.

*

**

I/We confirm that all information supplied is to the best of my/our knowledge correct and hereby covenant to indemnify and security issuer, the directors, the security registrar, the directors and officers of the

from and against all losses in respect thereof and all claims, actions, proceedings, demands, cost,expenses whatsoever which may be made or brought against them by reason of compliance with this request

Photo

forever keep indemnified the security registrar


Instruction:


THE REGISTRAR EDC REGISTRARS LIMITED RC 475195 154 IKORODU ROAD, ONIPANU, LAGOS

I/We hereby request that henceforth, all my/our Dividend Payment(s) due to me/us from my/our holdings in all the companies ticked at the right hand column be credited directly to my/our bank detailed below:


Bank Name

Bank Branch/Address

Bank Account Number


Shareholder Account Information Surname/Company name First name Other Names

Address:

City State Country


CHN (If any)

Mobile Telephone (1) Tel (2) E-mail Address

Signature(s) Company Seal (if applicable)

Joint/Company’s Signatories Authorised Signature of Bank/Stamp

For enquiries, please call 01-4538671-4 or send email to [email protected]

Kindly tick & quote your shareholder account no. in the box below:

Tick

Name of Company

Shareholder Number

Adswitch Plc

Afromedia Plc

Courteville Bus. Solutions Plc

Cutix Plc

Dangote Flour Mills Plc

Imo State Government Bond

Plateau State Government Bond

Resourcery Plc


E-DIVIDEND ACTIVATION FORM


(To be stamped by Bankers) Please write your name at the back of your passport photograph

EDC REGISTRARS LIMIITED

AffixCurrentPassport


Write your name at the back ofyour passport photograph


Instruction Only Clearing Banks are acceptable

Please complete all section of this form to make it eligible for processingand return to the address below

The Registrar,Apel Capital & Trust Ltd.8, Alhaji Bashorun StreetOff Norman Williams Str, S.W Ikoyi Lagos.

I\We hereby request that henceforth, all my\our Dividend Payment(s) due tome\us from my\our holdings in all the companies ticked at the right handcolumn be credited directly to my \ our bank detailed below:


Bank Name

Bank Account Number


Shareholder Account InformationSurname / Company’s Name First Name Other Names

Address :

City


CHN (If any)

State Country


Email Address



Company Namew.xxxxxxxx.com; E-mail: [email protected]



TICK NAME OF COMPANY SHAREHOLDER’SACCOUNT NO.

ABACUS MONEY MARKETFUND

ANINO INT’L PLC

CHAPEL HILL DENHAMMONEY MARKET FUND

EQUITY ASSURANCE PLC

FIRST ALUMINUM PLC

INTERLINKEDTECHNOLOGIES PLC

INTERNATIONALBREWERIES PLC

LASACO ASSURANCEPLC

LEAD UNIT TRUST SCHEME

MBA MUTUAL TRUSTSCHEME

MASS TELECOMINNOVATION PLC

NCR (NIGERIA) PLC

NEM INSURANCE PLC

PARAMOUNT EQUITY

PHARMA DEKO PLC

Email: [email protected] Tel : +234 (1) 293 2121 Address : 8, Alhaji Bashorun Street,W: www.apel.com.ng +234 (0) 704 612 6698 Off Norman Williams Crescent,

S.W. Ikoyi Lagos

THE INITIATES PLC

E-DIVIDEND ACTIVATION FORM

Instruction

Please complete all section of this form to make it eligible for processingand return to the address below


Surname

Bank Name

Bank Branch

Bank Account Number

Bank Address

First Name Other Names

Address :


City Country

Mobile Telephone 1

Signature(s)


Company’s Seal

State

Email Address

First Registrars & Investor Services Limited...connecting you to your wealth.

website:www.firstregistrarsnigeria.com; E-mail: [email protected]

E-DIVIDEND


AffixCurrent

Passport(To be stamped by Bankers)



Account Type (Tick) Current Savings

The Registrar,First Registrars & Investor Services Ltd. 2 , A b e b e V i l l a g e R o a d , I g a n m u P. M. B. 12692 Lagos. Nigeria.

I\We hereby request that henceforth, all my\our dividend Payment(s) due to me\us from my\our holdings in all the companies ticked at the right handcolumn be credited directly to my \ our bank detailed below:


CHN (If any)

Mobile Telephone 2

TICK NAMES OF COMPANY SHAREHOLER’S

ACCOUNT NUMBER

ABC TRANSPORT PLC ACAP CANARY GROWTH FUND AFRICAN DEVELOPMENT BANK BOND AFRICAN PAINTS PLC ASSET & RESOURCE MANAGEMENT COMPANY

LTD(FUND)

ARM AGGRESSIVE GROWTH FUND ARM ETHICAL FUND ASO-SAVINGS AND LOANS PLC AUSTIN LAZ AND COMPANY PLC BANK PHB PLC (NOW KEYSTONE BANK LIMITED) BAYELSA STATE GOVERNMENT BOND BCN PLC-MARKETING COMPANY BOC GASES NIGERIA PLC CADBURY NIGERIA PLC CHAMS PLC COSTAIN WEST AFRICA PLC CORE INVESTMENT SCHEME (COINS) CORE VALUE ACCOUNT (COVA) CR SERVICES (CREDIT BUREAU) PLC CROSS RIVERS STATE GOVT BOND DAAR COMMUNICATIONS PLC DEAP CAPITAL MANAGEMENT & TRUST PLC DELTA STATE GOVT BOND DV BALANCED FUND EDO STATE GOVT BOND FAMAD NIGERIA PLC FBN FIXED INCOME FUND FBN HOLDINGS PLC FBN HERITAGE FUND FBN MONEY MARKET FUND FBN NIGERIA EUROBOND (USD) FUND FBN NIGERIA SMART BETA FUND FIDELITY BANK PLC FIDELITY BANK PLC BOND FORTIS MICROFINANCE BANK PLC FRIESLANDCAMPINA WAMCO NIGERIA PLC HONEYWELL FLOUR MILLS PLC INDORAMA ELEME PETROCHEMICALS COMPANY

STAFF COOP SOCIETY LTD

JULI PLC LAGOS STATE BOND 167.5 BILLION 2ND DEBT

ISSUANCE PROGRAMME N80 BILLION 4% (SERIES 1 BOND)

LAGOS STATE BOND 167.5 BILLION 2ND DEBT ISSUANCE PROGRAMME N87.5 BILLION 13.5% (SERIES 2 BOND)

LEARN AFRICA PLC LOTUS HALAL EQUITY EXCHANGE TRADED

FUND

NIGERIA POLICE MORTGAGE BANK PLC NIGERIAN BREWERIES PLC OANDO PLC ONDO STATE GOVT BOND OYO STATE GOVT BOND PARTNERSHIP INVESTMENT CO.PLC PRESCO PLC PRESTIGE ASSURANCE PLC PZ-CUSSONS NIGERIA PLC RAK UNITY PETROLEUM PLC REDEEMED GLOBAL MEDIA COMPANY SIM CAPITAL ALLIANCE VALUE FUND STACO INSURANCE PLC STANBIC IBTC BANK PLC FLOATING RATE&

FIXED RATE SUBORDINATED UNSECURED NOTES BOND TRANCHE A & B

STANBIC IBTC BOND FUND STANBIC IBTC ETF 30 FUND STANBIC IBTC ETF 40 FUND STANBIC IBTC BALANCED FUND STANBIC IBTC DOLLAR FUND STANBIC IBTC ETHICAL FUND STANBIC IBTC GUARANTEED INCOME FUND STANBIC IBTC HOLDINGS PLC STANBIC IBTC MONEY MARKET FUND STANBIC IBTC NIGERIAN EQUITY FUND STANDARD ALLIANCE INSURANCE PLC STARCOMMS PLC UBA FIXED RATE SUBORDINATED UNSECURED

NOTES BOND

UNION DIAGNOSTIC AND CLINICAL SERVICES PLC

UPDC REITS VANTAGE BALANCED FUND (INCOME &

ACCUMULATED)

VANTAGE GUARANTEED INCOME FUND WEST AFRICAN ALUMINIUM PRODUCTS (WAAP) ZAMFARA STATE BOND


(To be stamped by Bankers) Write your name at the back of your passport photograph


TICK NAME OF COMPANY SHAREHOLDER’S ACCOUNT NO.

Instruction Only Clearing Banks are acceptable Please complete all section of this form to make it eligible for processing and return to the address below

The Registrar, Flour Mills Registrars Limited 34, Eric Moore Road, Iganmu (Bagco Building) Surulere P.O.Box 341, Apapa, Lagos State. I\We hereby request that henceforth, all my\our Dividend Payment(s) due to me\us from my\our holdings in all the companies ticked at the right hand column be credited directly to my \ our bank detailed below:


Bank Name

Bank Account Number




Address :

City


CHN (If any)

State Country


Email Address



Help Desk Telephone No/Contact Centre Information for Issue resolution or clarification: +234-1-7732568

Flour Mills Registrars Limited website:www.fmnregistrar.com; E-mail: [email protected]

Instruction

The Registrar

GTL REGISTRARS LIMITED

No 2, Burma Road

Apapa

Lagos

I\We hereby request that henceforth, all my\our Dividend Payment(s) due to me\us from my\our holdings in all the companies ticked at the right hand column be credited directly to my \ our bank detailed below:


Bank Name



Address

*Mobil Number 1 *Mobil Number 2

TICK COMPANY NAME SHAREHOLDERS ACCOUNT NO.

Abplast Products PLC

Aluminium Extrusion PLC

Cashew Nut Processing Industries PLC

Chellarams PLC

Christlieb PLC

DANA Group Of Companies Plc Series Tranche 1 & 2

DN Meyer PLC

DN Tyre & Rubber PLC

Ecobank Transnational Incorporated

Ekiti State Bond Tranche 1 & 2

EKOCORP PLC

Eterna Oil PLC

First Aluminium PLC

General Telecoms PLC

GlaxoSmithKline Nigeria PLC

Global Biofuels Nigeria Limited

Great Nigeria Insurance PLC

Ikeja Hotels PLC

Impresit Bakolori PLC

Industrial &General Insurance PLC

IPWA PLC

John Holts PLC

Julius Berger Nigeria PLC

Kajola Integrated &Investment Company PLC

Lennards Nigeria PLC

Local Contractors Receivables Bond Tranche 1,2 & 3

Mobil Oil Nigeria PLC

Nestle Nigeria PLC

Nigeria Cement Company PLC

Nigeria Reinsurance

Nigerian Enamelware Company PLC

Nigerian Lamps Industries

Nigerian Wire & Cable PLC

Okitipupa Oil Palm PLC

Oluwa Glass COMPANY

Seven-Up Bottling Company PLC

The Tourist Company of Nigeria

PLC

Tripple Gee & Company PLC

UBA Fixed N20 Billion Bond Series

1 Bond

UBN Property Limited

Unilever Nigeria PLC

Union Assurance Company Limited

(NOW Ensure Insurance)

Union Bank of Nigeria PLC

Union Homes REITS

Union Homes Savings & Loans PLC

University Press PLC

WEMA Bank PLC

Surname/Company Name First Name Other Name

City State Country


CSCS Clearing House Number

GTL Registrars Limited

Website: www.gtlregistrars.com. Email [email protected]


Please complete all section of this form to make it eligible for processing and return to the address below


Affix Current

Passport (To be stamped by Bankers)


Bank Account Number

Shareholder’s Signature

Joint/Companies Signatures

Email Address

Company Seal (If applicable)

Help Desk Telephone No/Contact Centre Information for Issue resolution or clarification:

234-(0)1-2917747, +234-(0)1-2793160-2.

Instruction Please complete all section of the forms to make eligible for processing and return to the address below The Registrar, Lighthouse Registrars Limited Kingsway Building, 3rd Floor, 2/4 Davies Street P.O. Box 60276 Lagos Nigeria. I/We hereby request that henceforth, all my/our dividend payment due to me/us from our holdings in Cornerstone Insurance plc be credited to my/our bank detailed below:

Clearing House No Bank Verification No Bank Name Bank Branch Bank Address Bank Account Number Account Opening Date Account Type (Tick) Current Savings Shareholders Account Information

Surname First Name Other Names

Address: City State Country



Email Address

Signature(s) Company’s Seal(If applicable) Joint/Company’s Signatories

Help Desk Telephone No/Contact Centre Information for Issue resolution or clarification: +2348087901770

TICK NAME OF COMPANY SHAREHOLDER ACCOUNT NO

CORNERSTONE INSURANCE PLC



Write y Write your name at the back

of you of your passport photograph


Lighthouse Registrars Ltd Website: www.lighthousereg.com; E-mail: [email protected]

MainstreetBank Registrars Ltd





Instruction Only Clearing Banks are acceptable Please complete all section of this form to make it eligible for processing and return to the address below

The Registrar, MainstreetBank Registrars Limited 2A Gbagada Expressway, Anthony, P.M.B. 12974 Lagos. I\We hereby request that henceforth, all my\our Dividend Payment(s) due to me\us from my\our holdings in all the companies ticked at the right hand column be credited directly to my \ our bank detailed below:


Bank Name

Bank Account Number




Address :

City


CHN (If any)

State Country


Email Address



Help Desk Telephone No/Contact Centre Information for Issue resolution or clarification: 234-7038979850 or 234-7038037680

Company Name website:www.mainstreetbankregistrars.com; E-mail: [email protected]

AFRICAN ALLIANCE INSURANCE PLC TICK NAME OF COMPANY

UNIVERSAL INSURANCE PLC GOLDEN GUINEA BREWERIES PLC MULTIVERSE RESOURCES PLC OMATEK VENTURES PLC NIGERIAN ROPES PLC NIGER STATE GOVERNMENT BOND




Instruction Only Clearing Banks are acceptable Please complete all sections of this form to make it eligible for processing and return to the address below

The Registrar Meristem Registrars Limited 213, Herbert Macaulay Way Adekunle-Yaba Lagos State

I\We hereby request that henceforth, all my\our Dividend Payment(s) due to me\us from my\our holdings in all the companies ticked at the right hand column be credited directly to my \ our bank account detailed below:


Bank Name

Bank Account Number



Surname/Company’s Name First Name Other Names

Address:

City


CHN (If any)

State Country


Email Address



Help Desk Telephone No/Contact Centre Information for Issue resolution or clarification: 01-2809250-4

Meristem Registrars Limited website:www.meristemregistrars.com; E-mail: [email protected]

TICK NAME OF COMPANY SHARE A/C NO

AFRINVEST EQUITY FUND

AIRLINE SERVICE & LOGISTICS PLC

BERGER PAINTS NIG PLC

CHELLARAMS BOND

CONOIL PLC

CONSOLIDATED HALLMARK INS. PLC

CUSTODIAN & ALLIED PLC

COVENANT SALT NIGERIA LIMITED

EMPLOYEE ENERGY LIMITED

ENERGY COMPANY OF NIGERIA PLC [ENCON]

eTRANZACT INTERNATIONAL PLC

FIDSON HEALTHCARE PLC

FOOD CONCEPTS PLC

FREE RANGE FARMS PLC

FTN COCOA PROCESSORS PLC

GEO-FLUIDS PLC

JUBILEE LIFE MORTGAGE BANK LTD

MAMA CASS RESTAURANTS LIMITED

MCN DIOCESE OF REMO

MCN LAGOS CENTRAL

MCN TAILORING FACTORY [NIGERIA] LIMITED

MULTI-TREX INTEGRATED FOODS PLC

MUTUAL BENEFITS ASSURANCE PLC

NASSARAWA STATE GOVT BOND

NASCON ALLIED INDUSTRIES PLC

NEIMETH INT’L PHARMS PLC

NIGER INSURANCE PLC

NIGERIA MORTGAGE REFINANCE COMPANY [NMRC] PLC

NIGERIA MORTGAGE REFINANCE COMPANY PLC [NMRC] BOND

ONWARD PAPER MILLS PLC

PACAM BALANCED FUND

PAINTS & COATINGS MANUFACTURERS NIG PLC

PROPERTYGATE DEVT. & INVEST. PLC

R.T. BRISCOE NIGERIA PLC

REGENCY ALLIANCE INSURANCE PLC

SMART PRODUCTS NIGERIA PLC

SOVEREIGN TRUST INSURANCE PLC

TANTALIZERS PLC

THE BGL NUBIAN FUND

THE BGL SAPPHIRE FUND

THOMAS WYATT PLC

VITAFOAM NIGERIA PLC

VONO PRODUCTS PLC

ZENITH EQUITY FUND

ZENITH ETHICAL FUND

ZENITH INCOME FUND

Meristem Registrars Limited

Web: www.meristemregistrars.com; email: [email protected]


Kindly Select the Company(s) in which Shares are held: TICK NAME OF COMPANY SHAREHOLDER’S ACCOUNT NUMBER Avon Crown Caps & Con. (Nig.)

BEMIL Nigeria Limited

Capital Oil Plc.

Channel Petroleum Plc.

Stokvis Nigeria Plc

FUMMAN Agric. Prod. Plc

Heritage Bank Ltd.

Int’l Energy Insurance Plc.

Naturelle Extracts Plc.

PANAfrican Capital Plc.

Secure Electronic Tech. Plc.

Spring Life Assurance Plc

Swap Tech. & Telecoms Plc.

United Mortgage Plc.

.............................................

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INDIVIDUAL JOINT SHAREHOLDER CORPORATE SHAREHOLDER

Surname / Company’s Name

First Name Other Names (for individual Shareholders only)

Current Postal Address

City State Country

Mobile (GSM) Phone Number

Land Phone Number/GSM

Previous Postal Address (If any)

Bank Name

e-DIVIDEND ACTIVATION FORM

Shareholder’s Signature or Thumbprint

Shareholder’s Signature\Joint

PAC REGISTRARS LTD. No. 122 Bode Thomas Road, Surulere, Lagos P.M.B. 3456, Surulere, Lagos. TEL: +234 01-7734381, 09086790272

E-MAIL: [email protected] WEBSITE: www.pacregistrars.com

This form must be signed by ALL, the registered holders, executor(s) or Administrator(s)

Company Seal/Incorporation Number (Corporate Shareholder)

RC 650108

I/We, hereby request that henceforth, all my/our dividend/coupon payment due to me/us from the paying company indicated below be paid to my/our bank account stated hereunder.

Bank Verification Number (BVN)

Bank Account No: Account Opening Date

INSTRUCTION: Please complete all section of this form to make it eligible for processing and return to the address above.

Only Clearing Banks are Acceptable




Shareholder’s CHN (If Known)

D D M M Y Y Y Y

PLEASE COMPLETE IN BLOCK LETTERS

Title: Mr. Mrs. Miss.

Others D D M M Y Y Y Y)

Date

SHAREHOLDER’S ACCOUNT INFORMATION

C

E-mail Address

DISCLAIMER "In no event shall PAC REGISTRARS be liable for any damages, losses or liabilities including without limitation, direct or indirect, special, incidental, consequential damages, losses or liabilities, in connection with your use of this form or your inability to use the information, materials, or in connection with any failure, error, omission, defect, delay in operation or transmission, or system failure, even if you advice us of the possibility of such damages, losses of expenses, whether express or implied in respect of such information."



The Registrar, UNITED SECURITIES LIMITED RC 126257

9, Amodu Ojikutu Street, Off Bishop Oluwole Street, Victoria Island, P.M.B 12753 Lagos, Nigeria.


Bank Name


Address:

City


CHN (If any)

State Country


Email Address



For inquiries, please call 01-2714566-7 or send e-mail to [email protected]

Website: www.unitedsecuritieslimited.com ; E-mail: [email protected] or the completed update form can also be submitted through any Access Bank PLC nearest to you.

“UNITED SECURITIES LIMITED hereby disclaims liability or responsibility for errors/omissions/misstatements in any document transmitted electronically”

Kindly tick & quote your shareholder account no in the box below

Tick Name of Company Shareholder Number

Access Bank PLC

Afrinvest WA Ltd

AIICO Insurance PLC

AIICO Money Market Fund

BSS Industries Ltd

Caverton Offshore Support group

Dangote Cement PLC

First Securities Discount House

Food Emporium Int`l Limited

Gombe State Government

IHS Nigeria PLC

MCNichols Consolidated PLC

NDEP PLC

NIPCO PLC

Red Star Express PLC

Skye Fixed Income Fund

Three Point Industries Ltd

Trust Bond Mortgage Bank PLC

WAPIC Insurance PLC



Bank Account Number

Instruction


E-MANDATE ACTIVATION FORM

Affix Current Passport (To be stamped by bankers) Please write your name at the back of your passport photograph


UNITED SECURITIES LIMITED Website: www.unitedsecuritieslimited.com ; E-mail: [email protected] or the completed update form can also be submitted through any Access Bank Plc nearest to you.

“UNITED SECURITIES LIMITED hereby disclaims liability or responsibility for errors/omissions/misstatements in any document transmitted electronically”


Instruction

Please complete all section of this form to make it eligible for processing and return to the address below The Registrar, Unity Registrars Limited 25 Ogunlana Drive, Surulere,Lagos Lagos State.



Bank Name

Bank Account Number


Shareholder Account Information Surname / Company’s Name First Name Other Names

Address :

City State Country


CHN (If any)


Email Address



TICK NAME OF COMPANY SHAREHOLDERS

ACCOUNT NO

AFROIL PLC

BGL PLC

CARANDA MANAGEMENT SERV. LTD

DVCF OIL & GAS FUND

DVCF OIL & GAS PLC

LOTUS CAPITAL HALAL FUND

NORTHLINK BROKERS PLC

PELICAN PRINTS LIMITED

ROKANA PLC

UNITY BANK PLC

UNITY REGISTRARS LTD

UNITYKAPITAL ASSURANCE PLC

Affix

Current Passport

UNITY REGISTRARS LIMITED Website: www.unityregistrarsng.com Email: [email protected]

http://www.unityregistrarsng.com/

VERITAS REGISTRARS LIMITED. Plot 89A, Ajose Adeogun Street, P.O. Box 75315, Victoria Island, Lagos

Telephone: (01) 2708930-4, 2784167–8; Fax:(01)2704085

[email protected]

www.veritasregistrars.com

VERITASREGISTRARS

e-DIVIDEND MANDATE FORM

TICK NAME OF COMPANYSHAREHOLDER’S

ACCOUNT No.

DANGOTE SUGAR

REFINERY PLC

FORTE OIL PLC

GUINNESS NIG. PLC

MAY & BAKER NIG. PLC

ZENITH BANK PLC

OSUN STATE BOND – S1

OSUN STATE BOND – S2

FLOUR MILLS BOND

RC: 510155

Shareholder’s Signature or ThumbprintCompany Seal/Incorporation No. (Corporate Shareholder)

Affix Current

Passport(To be Stamped by Bankers)

Please write your name at the back of your passport

photograph

(formerly Zenith Registrars)

INSTRUCTIONPlease complete all sections of this form to make it eligible for processingand return to the address below:

The RegistrarVeritas Registrars Limited89, Ajose Adeogun StreetVictoria IslandLagos.

I/We hereby request that henceforth, all my/our dividend payment(s) dueto me/us from my/our holdings in all the companies ticked at the right handcolumn be credited directly to my/our bank detailed below:


Bank Name

Bank Account Number


SHAREHOLDER ACCOUNT INFORMATION

Surname/Company Name First Name Other Names

Address:

City State Country


CHN(if any)


E-mail Address

Shareholder’s Signature or Thumbprint

Please note that Only Clearing Banks are acceptable

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