Remarks.

LIST OF PERSONs holding shares in the

Company Limited, on the

day of

19

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.

§ Particulars of shares

transferred since the date of the last return by persons who are still

members.

§ Particulars of shares transferred since the date of the last return by persons who have ceased to be members.

Date of

| Number.

registration Number.

of transfer.

Date of

registration of transfer.

Occupation.

† Number of shares

held by existing mem-

bers at date of return.

COMPANIES.

No. 58 of 1911.

2175

Schedule. [Third

Form E

contd.

†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 sub-divided 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 the transferee may be inserted in the "Remarks" column immediately opposite the particulars of each transfer.

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