Australian Standard Transfer Form

AUSTRALIAN STANDARD

TRANSFER FORM

AFFIX OR IMPRESS STAMP DUTY HERE

IMPRESS MARKING / CERTIFICATION STAMP HERE

FULL NAME OF

COMPANY OR

ELIGIBLE BODY

Class

If not fully paid, paid to

Register

FULL DESCRIPTION

OF SECURITIES

Words

QUANTITY

Figures

SELLING BROKER’S STAMP

Mr

Surname(s)

Mrs

Given Name(s)

FULL

Miss

NAME(S)

OF

SELLER(S)

Address

Please use BLOCK letters

Date of Purchase

CONSIDERATION

$A

S/Duty = $ A

/

/

SIN/SBN/IPN

HIN

TOTR

Uncertificated

Transferor

Identification

Surname(s)

Mr

FOR USE BY AUSTRALIAN

Mrs

SELLING BROKERS ONLY

FULL

Miss

NAME(S)

OF

BUYERS(S)

Given Name(s)

TRANSFER IDENTIFICATION

NUMBER

Please use BLOCK letters

FULL

POSTAL

Transferor’s Broker

ADDRESS

Hereby certifies:-

OF

(a)

As to the validity of Documents

BUYER(S)

(b)

That Stamp Duty, if payable has been or will be

paid.

REMOVAL

Please enter these securities on the

REGISTER

REQUEST

SIN/SBN/IPN

HIN

TETR

Uncertificated

Transferee

Identification

·

I/We the registered holder(s) and undersigned Seller(s) for the above consideration do hereby transfer the above names(s) hereafter, called the Buyer(s) or to the several buyers

named in Part 2 of the brokers Transfer Form(s) or Split Transfer form(s), the Securities as specified above standing in my/our name(s) in the books of the above-named Company

or eligibly body subject to the several conditions on which I/We held the same at the time of signing hereof and I/We the Buyer(s) do hereby agree to accept the said securities

subject to the same conditions.

·

I/We the registered holder(s) and undersigned Seller(s) hereby transfer the above securities to the several transferees name in Part 2 of the Brokers Transfer Form(s) or Split

Transfer Form(s) relating to the above securities.

TRANSFEROR’S BROKER STAMP

·

I/We have not received any notice of revocation of the Power of Attorney by death of the grantor or otherwise, under which the transfer is signed.

·

Delete whichever does not apply.

Affixed at

On:-

è

FOR COMPANY USE

SELLER(S)

SIGN HERE

DATE SIGNED

/

/

è

BUYERS(S)

SIGN HERE

DATE SIGNED

/

/

LODGING AGENT’S STAMP