To „DISL SECURITIES” JSC Via Investment Intermediary

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To
„DISL SECURITIES” JSC
Via Investment Intermediary:.................................... General № in CSD: ................
Date: .............2013
Hour:......................
ORDER FOR SUBSCRIPTION OF CONVERTIBLE CORPORATE BONDS
In accordance with a decision adopted at the General Meeting of Shareholders of “Sofia
Commerce - Pawn Shops” Jsc from 15.04.2013 on the issuance under the terms and
conditions of initial public offering of an issue of dematerialised, interest-bearing,
convertible, freely transferrable and unsecured bonds and notices of public offering,
published in the newspapers „Novinar” on 28.10.2013, „Capital Daily” on 28.10.2013, the
announcement made public via Trade Register on 18.10.2013.
□ CLIENT, OWNER OF THE RIGHTS:
Name/Company:_________________________________________________________
PIN/EIK code: ___________________________________________________________
Address for correspondence: __________________________________________________
□ PROXY/REPRESENTATIVE:
Name:__________________________________________________________________
PIN: __________________________________________________________________
Address for correspondence: __________________________________________________
Notary certified power of attorney №_______/___________
NUMBER OF OWNED RIGHTS FOR SUBSCRIPTION OF BONDS:
ISIN code: BG4000013137, Exchange code: 6SOK
........................ (.............................................................................)
THE CLIENT/ HIS/HER PROXY/REPRESENTATIVE DECLARE UNRESERVEDLY AND
IRREVOCABLY THAT HE/SHE DESIRES TO ACQUIRE AND PAY THE FOLLOWING
FINANCIAL INSTRUMENTS IN THE COURSE OF ISSUING:
TYPE: Dematerialized, interest-bearing, convertible, freely transferable and unsecured
bonds
ISSUER: “Sofia Commerce - Pawn Shops” Jsc
NUMBER OF BONDS: ................(.........................................................................)
ISSUANCE VALUE PER A BOND: EUR 100
TOTAL ISSUE VALUE: EUR ................. (..............................................)
CORRELATION OWNED RIGHTS/SUBSCRIBED BONDS: 96/1,
96 rights entitle to subscribe 1 (one) bond. If rights are not multiples of 96, the number
of bonds which the holder is entitled to record shall be rounded to the lesser whole number.
METHOD OF PAYMENT:
On escrow account of “Sofia Commerce - Pawn Shops” Jsc:
Bank: International Asset Bank
IBAN: BG52IABG80985401749000, BIC code: IABGBGSF
PAYMENT DEADLINE: 12.12.2013г.
CLIENT BANK ACCOUNT
(in case the subscription is terminated and/or announced unsuccessful the paid amount should be refund to the
following bank account)
IBAN _________________________________________________
BIC code ________________, Bank _______________________
DECLARATION under art.34, p. 8 of Ordinance № 38 on the requirements to the activities of the
investment intermediaries
The undersigned ________________________, PIN code _________, acting as: ( ) broker; ()
person under Article 39, Paragraph 1, and Section 2 of Ordinance № 38 via Investment
Intermediary_____________
DECLARE that I have verified the identity of: ( ) the Client ( ) the representative of the Client at
the time of submission of the present subscription and that the person put his/her signature in my
presence.
Date:
____________
/signature /
Declarer: _____________
DECLARATION under art.35, p.1, art.25, p.1 and art.37, p.1.2 of Ordinance № 38 on the
requirements to the activities of the investment intermediaries
By signing the present the client/his/her representative declare:
1. ( ) possess (x) do not possess insider information for the financial instruments to which the order
refers and for their issuer if the financial instruments are traded on a regulated market;
2. Financial instruments - object of the order for sale or exchange ( ) are (x) are not blocked in a
depository institution, ( ) has (x) has not established pledge on them or ( ) has (x) has not imposed orders;
3. The transaction – object of the order, ( ) constitutes (x) does not constitute concealed purchase or
sale of financial instruments;
4. ( ) execute (x) have not executed and ( ) have executed (x) have not executed for the last year
before the signature of the present agreement, transactions with financial instruments professionally;(to be
filled by proxy)
5. In the interest of the client is to acquire securities, after reading the Prospectus for public offering
of bonds, issuing by the Company, confirmed by Decision № 749-E Е/08.10.2013, and (x) has received a
copy () has not received by the later.
6. Is being informed that it is not acceptable subscribing of securities or transactions with securities
and payments in regards with it, before the FSC has confirmed the Prospectus for public offering of the
relevant securities, and no earlier than 7 days after the publication notice of initial public offering under
Art. 92а of the Law on Public Offering of Securities.
Date: ____________
Declarer: _____________
The subscription is considered valid only if the total issue amount of the subscribed bonds is deposited
at the moment of the submission of application. In partial payment of the issue value subscribed are
number of shares for which the same is fully paid.
Subscription applications:
1) Natural persons shall submit the subscription in person, by themselves with an identity document, a copy of
which is attached to the application or by proxy, which is legitimized by a notarized explicitly power of attorney
and an identity document.
2) Legal entities submit the subscription through their legitimate representatives or by an authorized person.
When the legal entity is registered/re-registered under the Commercial Register Act shall present the following
verified copies:
 EIK code (unified identification code for legal entities) from the Registration Agency;
 Identity document of natural persons - legal representatives of the legal entity;
When the legal entity is not registered under the Commercial Register Act shall present the following verified
copies:
 Certificate of current legal status of the entity; 
 BULSTAT and VAT registration;
 Identity document of natural persons - legal representatives of the legal entity;
 Notarized explicitly authorization and identity card of the proxy - in filing proxy;
3) Foreign legal entities shall submit translated and legalized appropriately documents.
D.I.S.L. Securities keeps for its records the documents under p.1) and 2).
For Investment Intermediary : _______________
/signature and stamp/
CLIENT:________________
/signature and stamp/
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