1 TRANSFER form FOR NON-MARKET TRANSACTIONS All Correspondence please send to;. PO Box 52. Please use a black pen and print in CAPITAL letters Collins Street West VIC 8007. Phone: 1300 992 916. 1. Stamp Duty may be applicable in your state. Please note any DSSOLFDEOH payment of stamp duty Facsimile: +61 8 9315 2233. on the TRANSFER of the Securities is the responsibility of the Buyer(s). Email: 2. Full name of Company 3. State of Incorporation or Corporation 4. Description of Securities (Shares, Class If not fully paid, paid to options etc.). 5. Quantity of Securities Words Figures 6. Full name(s) of Transferor(s) or Seller(s) .. 7. Securityholder Reference SRN : Number (must be quoted). 8. Consideration IRU 6 HFXULWLHV 9. Date of Purchase $. / /. 10. Full name(s) of Title Given Name(s) Surname Transferee(s) or Buyer(s). Mr } .. Mrs }.. Ms }. Miss } .. Dr } .. 11. Buyers Securityholder Reference Number (if applicable).
2 SRN : 12. Full postal address of Transferee(s)/Buyer(s) .. State/Country Postcode I/We the registered holder/s and undersigned seller/s for the above consideration do hereby TRANSFER to the above name/s hereinafter called the Buyer/s the securities as specified above standing in my/our name/s in the books of the above named Company, subject to the several conditions on which I/We held the same at the time of signing hereof and I/We the Buyer/s do hereby agree to accept the said securities subject to the same conditions. I/We have not received any notice of revocation of the Power of Attorney by death of the grantor or otherwise, under which this TRANSFER is signed. 13. Transferor(s). Individual or Securityholder 1 Securityholder 2 Securityholder 3. (Sellers) sign here Sole Director or Sole Secretary Director Director/Secretary 14. Date: _____/ _____ / _____. 15. Transferee(s). (Buyers) sign here Individual or Securityholder 1 Securityholder 2 Securityholder 3.
3 Sole Director or Sole Secretary Director Director/Secretary 16. Date: _____ / _____ / _____. DO NOT USE THIS form IF YOU ARE TRANSFERRING/BUYING/SELLING BROKER SPONSORED/CHESS HELD SECURITIES. YOU MUST CONTACT YOUR BROKER TO PERFORM THIS TRANSACTION. GUIDELINES ON COMPLETING THE TRANSFER form FOR NON-MARKET TRANSACTIONS. WHEN TRANSFERRING SHARES IN A LISTED OR UNLISTED COMPANY. 1. STAMP DUTY. Transfers of securities that are listed and quoted on an Australian Stock Exchange are exempt from Stamp Duty. However, Stamp Duty may be applicable on all other securities by the buyer of the shares. Please note that it is not the responsibility of Security TRANSFER Australia to provide/. pay for any potential Stamp Duty. Transfers must be submitted to the respective State or Territory Stamp Duty office for Assessment and payment of any applicable duty. Go to respective states Revenue website for more information.
4 2. FULL NAME OF COMPANY OR CORPORATION. The full name of the company or corporation in which the securities are held. 3. STATE OF INCORPORATION. State in which the Company (item 2) is incorporated in. This can be found on the securities certificate, statement or other notices received from the company. 4. DESCRIPTION OF SECURITIES. Fully Paid Ordinary Shares, 9% Unsecured Convertible Notes etc. 5. QUANTITY OF SECURITIES. Number of securities being transferred in both words and figures. One Hundred. 100. 6. FULL NAME(S) OF TRANSFEROR(S) OR SELLER(S). Full names must be included. 7. SECURITY HOLDER REFERENCE NUMBER. This number must be quoted when transferring securities not represented by certificates. That is securities registered on the issuer sponsored (uncertificated) subregister. 8. CONSIDERATION FOR SECURITIES. Is the full amount paid in settlement of the TRANSFER of securities. Purchases should reflect the market price of shares as at the date of purchase.
5 It is not the responsibility of Security TRANSFER Australia to supply the market price nor enter into any form of negotiations on behalf of seller or buyer. 9. DATE OF PURCHASE. Insert the date of purchase or completion of the TRANSFER . 10. FULL NAME(S) OF TRANSFEREE(S) OR BUYER(S). Insert the full name(s) of the buyer(s) with a maximum of three joint holders. Securities may not be registered in the name(s) of a firm or a business, an estate, a deceased person, a minor, a fund or a trust. 11. BUYERS SECURITYHOLDER REFERENCE NUMBER. If the buyer is an existing holder in the company and is registered in the Issuer Sponsored (uncertificated) subregister please provide the existing Securityholder Reference Number. 12. FULL POSTAL ADDRESS OF TRANSFEREE(S)/BUYER(S). Insert a full address including the postcode. Please note only one address may be recorded. 13. TRANSFEROR(S)/SELLER(S) SIGNATURE(S). : The securityholder must sign.
6 Holdings: Where the holding is in more than one name, all of the securityholders must sign. of Attorney: To sign as a Power of Attorney, you must already be lodged with the registry as the Power of Attorney. Estate: When the holding is in the name of an estate, all the executors/administrators are require to sign. Probate requirements must also be complied with. : Director, Company Secretary, Sole Director and Sole Company Secretary can sign. Please indicate the office held under your signature. 14. DATE SIGNED. Insert Date signed by the Seller(s). 15. TRANSFEREE(S)/BUYER(S) SIGNATURE(S). : The securityholder must sign. Holdings: Where the holding is in more than one name, all of the securityholders must sign. of Attorney: To sign as a Power of Attorney, you must already be lodged with the registry as the Power of Attorney. Estate: When the holding is in the name of an estate, all the executors/administrators are require to sign.
7 Probate requirements must also be complied with. : Director, Company Secretary, Sole Director and Sole Company Secretary can sign. Please indicate the office held under your signature. 16. DATE SIGNED. Insert Date signed by the Seller(s). Note One: Copies of documents forwarded must be certified as a correct copy by a person who in the State or Territory of certification has the power to witness a Statutory Declaration. Note Two: Transfers or other documents that do not fully meet the company's requirements are liable to be returned unregistered.