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E-DIVIDEND MANDATE ACTIVATION FORM

Africa Prudential Registrars Plc@APRPlcINSTRUCTIONP lease complete all section of this form to make it eligible for processing and return to theaddress RegistrarAfrica Prudential Registrars Plc220B, Ikorodu Road, Palmgrove, MANDATE ACTIVATION FORMBank 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.

E-DIVIDEND MANDATE ACTIVATION FORM TICK SHAREHOLDER’SNAME OF COMPANY 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.

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