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Online Account Opening Form

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CENTRAL SECURITIES CLEARING SYSTEM LIMITED
(THE CLEARING HOUSE)
PARTICULARS OF SHAREHOLDERS

MEMBER CODE:	*
MEMBER NAME:	*
SHAREHOLDER'S TYPE:	*
CLEARING HOUSE NO. (CHN):	*
BIRTH DATE:	*
SHAREHOLDER'S SURNAME:	*
OTHER NAME:	*
MOTHER'S MAIDEN NAME:	*
CONTACT (IF CORPORATE):
SHAREHOLDER'S ADDRESS:	*
CITY:	*	COUNTRY:	POSTAL CODE
PHONE:		FAX:
REFERENCE NO:
COUNTRY OF ORIGIN:	*

WAIVER
I/We
am(are) a prospective shareholder(s) in companies listed on The Nigerian Stock Exchange and I (we) hereby FREELY state that being aware of my(our) right t be issued with a share cerfiticate(s) under section 146 and 147 of the Companies and Allied Matters Decree 1990 and the Memorandum and Articles of Association of the listed companies for my (our) sole benefit and private purpose do hereby waive the said right and also DECLARE that I (we) shall accept as sufficient certification of my (our) shareholding any memorandum to that effect delivered to me (us) by the said listed company/companies or the central securities clearing system limited acting on behalf of same as satisfaction of my said right under the sections and memorandum and Articles of association aforementioned.

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