Name Correction Request And Indemnity Page 2
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2How to complete this form
A
Name Correction Request and Indemnity
Complete this section with the correct name(s) details that are required to be entered onto the register.
Note: This form can only be used for minor amendments to the registered name of a securityholder such as correction of
spelling, addition, deletion or change to a middle name.
Enter the name of a contact person and telephone number, these details will only be used in the event that the registry has a query
regarding this form.
Important notice: if you are a broker sponsored holder in CHESS, do not send this completed form to Computershare
Investor Services Pty Limited. You must contact your sponsoring broker to lodge a name correction request.
B
Signature(s)
You must sign this form as follows in the spaces provided:
Individual:
where the holding is in one name, the securityholder must sign.
Joint Holding:
where the holding is in more than one name, only the securityholder(s) changing their name must
sign.
Power of Attorney:
to sign under Power of Attorney, you must have already lodged this document with the registry.
If you have not previously lodged this document for notation, please attach an originally certified copy
of the Power of Attorney to this form when you return it.
Companies:
where the company is changing its name this form must be signed by either 2 Directors or a Director
and a Company Secretary. Alternatively, where the company has a Sole Director and, pursuant to the
Corporations Act, there is no Company Secretary, or where the Sole Director is also the Sole
Company Secretary, that Director may sign alone and is required to complete the warranty stating
that there is no Company Secretary by completing their name in full. Delete titles as applicable.
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