151 www.abbeymortgagebank.com I/We hereby declare that the information I have provided is true and correct and that I shall be held personally liable for any of my personal details. I/We also agree and consent that Africa Prudential Plc ("Afriprud") may collect, use, disclose, process and deal in any manner whatsoever with my/our personal, biometric and shareholding information set out in this form and/or otherwise provided by me/us or possessed by Afriprud for administration of my/our shareholding and matters related thereto. S S C C A A N N T T o o D D o o w w n n l l o o a a d d S S h h a a r r e e h h o o l l d d e e r r s s ’ ’ F F o o r r m m s s 21. TAX IDENTIFICATION NUMBER (TIN) 22.
152 www.abbeymortgagebank.com DATE OF BIRTH: On behalf of Plc/Ltd, we hereby agree jointly and severally keep the company and/or the Registrar or other persons acting on shares/stocks, and to pay you on demand, all payments, losses, costs and expenses suffered or incurred by you in consequence thereof or arising therefrom. We/I also agree and consent that Africa Prudential Plc ("Afriprud") may collect, use, disclose, process and deal in any manner whatsoever with my/our personal, biometric and shareholding information set out in this form and/or otherwise provided by me/us or possessed by Afriprud for administration of my/our shareholding and matters related thereto. GENDER:
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154 www.abbeymortgagebank.com 1. 2. 8. DATE OF BIRTH * I/We hereby declare that the information I have provided is true and correct and that I shall be held personally liable for any of my personal details. I/We also agree and consent that Africa Prudential Plc ("Afriprud") may collect, use, disclose, process and deal in any manner whatsoever with my/our personal, biometric and shareholding information set out in this form and/or otherwise provided by me/us or possessed by Afriprud for administration of my/our shareholding and matters related thereto. SCAN To Download Shareholders’ Forms E-SHARE PORTAL FORM
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