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SIXTII SCHEDULE.
FORM OF ANNUAL RETURN OF A COMPANY HAVING A SHARE CAPITAL.
Sections 107 and 347.
Annual Return of the
made up to the
Company, Limited
day of
19
(being the date of the first or only ordinary general meeting in 19 ).
J
The address of the registered office of the Company
as follows;
Summary of Share Capital and Shares.
Nominal Share Capital S
divided into*
Total number of shares taken up* to
the
day of
19
being the date of the return (which number must agree with the total shown in the list as held by existing members).
Number of shares issued subject to
payment wholly in cash.
Number of shares issued as fully paid
up otherwise than in cash.
Number of shares issued as partly paid
up to the extent of
otherwise than in cash.
+Number of
issued at a discount.
per share
shares (if any)
Total amount of discount on the issue $
of shares which has not been written
off at the date of this Return.
There has been called up on
each of shares,
§There has been called up on
each of shares,
§There has been called up on
each of shares.
Total amount of calls received, in- cluding payments on application and
allotment.
$
Total amount (if any) agreed to be $
considered as paid on
shares
which have been issued as fully paid
up otherwise than in cash.
Total amount (if any) agreed to be
considered as paid on
shares
which have been issued as partly
paid up to the extent of
per
shares of
ench. shares of
each.
-
share otherwise than in cash. Total amount of calls unpaid Total amount of the sums (if any) paid by way of commission in respect of any shures or debentures allowed by way of discount in respect of any debentures since the date of the last Return.
or
A
*Where there are shares of different kinds or amounts (e.g., Preference and Ordinary or $100 and $10) state number and nominal values separately.
tif the shares
separately.
are of different kinds, state
them
Where various amounts have been called, or there are shares of different kinds, state them separately.
tuclude what has been received on forfeited as well as on existing shares.
305