E-DIVIDEND MANDATE ACTIVATION FORM

1 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.

2 "AffixCurrentPassportWrite your name at the back ofyour 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 DM MYYYYSHAREHOLDER ACCOUNT INFORMATIONS urname/Company s NameFirst NameOther NameAddressCityStateCountryPrevious Address (if any)Clearing House Number (CHN) (if any)Name of Stockbroking FirmCMobile Telephone 1 Mobile Telephone 2E-mail AddressSignature:Joint/Company s SignatoriesSignature:Company Seal(if applicable)ONLY CLEARING BANKS ARE ACCEPTABLE1.

3 AFRICA PRUDENTIAL REGISTRARS PLC2. ABBEY MORTGAGE BANK PLC3. AFRILAND PROPERTIES PLC4. A & G INSURANCE PLC5. MIXTA REAL ESTATE PLC(formerlyARM Properties Plc)6. LIFE PLC7. ADAMAWA STATE GOVERNMENT BOND8. BECO PETROLEUM PRODUCTS PLC9. BUA GROUP10. BENUE STATE GOVERNMENT BOND11. CAP PLC12. CAPPA AND D'ALBERTO PLC13. CEMENT COY OF NORTHERN NIG. PLC14. CSCS PLC15. CHAMPION BREWERIES PLC16. COMPUTER WAREHOUSE GROUP17. EBONYI STATE GOVERNMENT BOND18. GOLDEN CAPITAL PLC19. INFINITY TRUST MORTGAGE BANK PLC20. INTERNATIONAL BREWERIES PLC21. INVESTMENT & ALLIED ASSURANCE PLC22. JAIZ BANK PLC23. KADUNA STATE GOVERNMENT BOND24. NEM INSURANCE PLC25.

4 NEXANS KABLEMETAL NIG. PLC26. OMOLUABI SAVINGS AND LOANS PLC27. PERSONAL TRUST & SAVINGS LTD28. MANDRIDES PLC29. PORTLAND PAINTS & PRODUCTS NIG. PLC30. PREMIER BREWERIES PLC31. RESORT SAVINGS & LOANS PLC32. ROADS NIGERIA PLC33. SCOA NIGERIA PLC34. TRANSCORP HOTELS PLC35. TRANSCORP PLC36. TOWER BOND37. THE LA CASERA CORPORATE BOND38. UACN Plc39. UBA BALANCED FUND40. UBA BOND FUND41. UBA CAPITAL PLC42. UBA EQUITY FUND43. UBA MONEY MARKET FUND44. UNITED BANK FOR AFRICA PLC45. UNIC PLC46. UAC PROPERTY DEVELOPMENT COMPANY PLC47. UTC NIGERIA PLC48. WEST AFRICAN GLASS IND PLCCLIENTELEA/C No. Affix Current Passport (To be stamped by Bankers) Write your name at the back of your passport photograph E-DIVIDEND MANDATE ACTIVATION form TICK NAME OF COMPANY SHAREHOLDER S ACCOUNT NO.

5 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 Mobile Telephone 1 Mobile Telephone 2 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 ; E-mail: BOC GASES NIGERIA PLC GREIF NIGERIA PLC NAME OF COMPANYACORN PET.

6 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 PLCNGC STERILENPF MICROFINANCE BANKNULEC INDUSTRIES PLCOKOMU OIL PALM PLCPREMIER PAINT PLCREAN PLCSKYE BANK PLCTOTAL NIG. PLCTRANEX PLCWOMEN INVESTMENT FUNDTICKACCOUNT S E-DIVIDEND MANDATE ACTIVATION form 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: Shareholder Account Information TICK NAME OF COMPANY SHAREHOLDER A/C NO.

7 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 Verification Number Bank Name Bank Account Number Account Opening Date 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: Tel no: +234-01-2902996, 4663631, 4543311, 07045355922 web: // e-mail: E-DIVIDEND MANDATE ACTIVATION form Please complete all sections of this form to make it eligible for processing and return to the address below The Registrar, Bank Name Surname / Company s Name First Name Other Names Address: City Previous Address (If any) CHN (If any) State Country Mobile Telephone 1 Mobile Telephone 2 Email Address Signature(s) Joint\Company s Signatories Website.

8 E-mail: 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 Account Opening Date Shareholder Account Information 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 Only Clearing Banks are acceptable Website: 2C, Gbagada Expressway, By Beko Ransome Kuti Park, Anthony Oke Bus Stop, Gbagada, 10014, Shomolu, Lagos State.

9 DataMax Registrars Limited AXA Mansard Insurance Trust Bank Mortgage Bank Limited IFC - Naija BondKogi State Bond Mainstream Energy SolutionsSeplat Petroleum Development Assurance (Sterling Trust Fund).Help desk , Telephone No. 01-712000-11, 0700 DATAMAX or send e-mail to REGISTRARS LIMITED ; E-Mail: 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 Company Secretary, Directors etc.

10 * Please ensure that the name on your Bank Account corresponds with your 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 requestPhotoforever keep indemnified the security registrarBank Verification Number Instruction.