Transcription of TICK NAME OF COMPANY INSTRUCTION - Veritas Registrars
1 Veritas Registrars LIMITED. Plot 89A, Ajose Adeogun Street, Box 75315, Victoria Island, LagosTelephone: (01) 2708930-4, 2784167 8; MANDATE FORMTICKNAME OF COMPANYSHAREHOLDER S ACCOUNT SUGAR REFINERY PLCFORTE OIL PLCGUINNESS NIG. PLCMAY & BAKER NIG. PLCZENITH BANK PLCOSUN STATE BOND S1 OSUN STATE BOND S2 FLOUR MILLS BONDRC: 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 )INSTRUCTIONP lease complete all sections of this form to make it eligible for processingand return to the address below:The RegistrarVeritas Registrars Limited89, Ajose Adeogun StreetVictoria ,allmy/ourdividendpayment(s)duetome/usfr ommy/ourholdingsinallthecompaniestickeda ttherighthandcolumnbecrediteddirectlytom y/ourbankdetailedbelow:Bank Verification NumberBank NameBank Account NumberAccount Opening DateSHAREHOLDER ACCOUNT INFORMATIONS urname/ COMPANY Name First NameOther Names Address.
2 CityStateCountryPrevious Address (if any)CHN(if any)Mobile Telephone 1 Mobile Telephone 2E-mail AddressShareholder s Signature or ThumbprintPlease note that Only Clearing Banks are acceptabl
