LIST OF PERSONS holding shares in the 19 5

Company Limited, on the

day of and of persons who have held shares therein at any time since the date of the last return, showing their names and addresses and an account of the shares so held.

Names, Addresses, and

Occupations.

Account of Shares.

Folio in Register Ledger

containing Particulars.

Surname.

Christian Name.

Address.

915 -

created after the] [or which would require registration if charges which are required to be regis- pany in respect of all mortgages and

tered with the registrar of companies, }§ Total amount of debt due from the com- -

19

day of STATEMENT in the form of a balance sheet made up to the

culars of the capital, liabilities, and assets of the containing the parti-

company.

existing shares.

Include what has been received on forfeited as well as on

nominal values separately. Preference and Ordinary, or $100 or $50) state the numbers aud

* When there are shares of different kinds or amonuts (e.g.,

or secretary of the company,

The Return must be signed at the end by the manager

§ State the aggregate number of shares forfeited (if any).

of different kinds state them separately.

† Where various amounts have been called or there are shares

Presented for filing by.

Particulars of Shares transferred since the Date of the last Return by Persons who are still

Members.

Num-

ber.+

§ Particulars of Shares transferred since the Date of the last Return by Persons who have ceased to be Members.

Date of

Num-

ber.

Registration of Transfer.

Date of

Registration of Transfer.

Remarks.

Occupation.

† Number of Shares

held by existing Mem- hers at Date of Return.

† The aggregate number of shares held,

and not the distinctive numbers, must be stated, and the column must be added up throughout so as to make one total to agree with that stated in the summary to have been taken up. When the shares are of different classes these columns may be subdivided so that the number of each class held or transferred may be shown separately.

§ The date of registration of each transfer should be given as well as the number of shares transferred on each date, The particulars should be placed opposite the name of the transferor and not opposite that of the transferee, but the name of transferee may be inserted in the "Remarks column immediately opposite the particulars of each transfer.

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