Scrip Dividend – Chapter 13
Name of Company1:
Nature of Transaction:
Name of Sponsor2/Adviser:
Date Submitted:
Rule
13.8.6 (1)(a)
13.8.6 (1)(b)
Page
Total number of shares which could
be issued
Details of dividend foregone
13.8.6 (1)(d)
Total cash payable + tax credit if no
elections
Date for ascertaining share price used
13.8.6 (1)(e)
Proportional entitlement
13.8.6 (1)(f)
How fractional entitlements will be
dealt with
Record date
13.8.6 (1)(c)
13.8.6 (1)(g)
13.8.6 (1)(h)
13.8.6 (2)
Proof Comment (where applicable)
Number
Form of election
(i) positive election
(ii)non transferable
Timetable agreed with RIE
Non-applicability Confirmation
We inform you that items marked “N/A” in the Page column of the above checklist are considered not
applicable and no equivalent information is available in relation to the enclosed document.
Signed by:
On behalf of3:
1
Name of issuer
Where a sponsor is appointed under LR 8.2.1R
3
The signatory should be properly authorised to do so on behalf of the issuer or, where LR8.2.1R applies, the sponsor
2
1
February 2014