NSE-Web-Prospectus-2014

Serial No.
Offer Opens: 9.00am, 24 July 2014
Closure Date: 4.00pm, 12 August 2014
For use with the Prospectus dated 9 July 2014 in respect of the ADMISSION TO LISTING of the NSE’s up to 194,625,000 issued and fully paid up
ordinary shares to the Main Investment Market Segment of The Exchange and OFFER FOR SUBSCRIPTION by the NSE of up to 66,000,000 new
ordinary shares of par value Kshs 4.00 each in the capital of the NSE at an offer price of Kshs 9.50 per ordinary share for Kshs 627,000,000. Before
completing this Application Form refer to the statement and instructions on the reverse of this Application Form and the terms and conditions of
the Offer in the Prospectus.
COMPLETE USING CAPITAL LETTERS
NAIROBI SECURITIES EXCHANGE LIMITED
Company Registration No. CPU/2014/144920
APPLICATION FORM
CDS ACCOUNT IS MANDATORY
This Application Form is Not For Sale
A. CDS ACCOUNT NO (MANDATORY)
CDA Code No. (no leading zeroes) (LI/LC/FI/FC)
Authorised Agent Stamp
B. BANK ACCOUNT (MANDATORY FOR KENYANS) To be completed by applicant/ Lender for refunds (if applicable)
Bank Name
(in Kenya)
Account No.
Branch
C. APPLICANT
(i) Primary Applicant: (names as per ID/Passport)
ID/Passport No.
Surname (Last Name)
First Name and Other Names (leave space between names)
Country of Issue
(ii) Joint Applicant: (names as per ID/Passport)
ID/Passport No.
Surname (Last Name)
First Name and Other Names (leave space between names)
Country of Issue
(iii) Company Name / Institution/ Custodian
Registration / Incorporation No.
Country of Registration / Incorporation
(iv) P.O. Box Post Code Town Country
Mobile No./ Telephone No.
Area Code Town Code Number
Email (important to provide)
D. APPLICATION
No. of Offer Shares applied
Amount Payable (Kshs)
(minimum 500, multiples 100)
(multiply by Kshs 9.50) (minimum Kshs 4,750) (add Kshs 30 for CDSC)
E. PAYMENT
(i) EFT Banker’s Cheque Ref No: (ii) Via Authorised Agent
(tick one option if applicable)
(tick if applicable)
(iii) Financed by Lender CDS Form 5 - Serial No.
(tick if applicable and complete E (i) above)
(attach to this form)
F. SIGNATURE/S
Signature 1 Signature 2 Company Seal/Stamp
Date 2 0 1 4
Tear-off
G. ACKNOWLEDGEMENT SLIP
Applicant
No. of Offer Shares applied
CDS A/C
CDA Code No. (no leading zeroes) (LI/LC/FI/FC)
Date 2 0 1 4
Authorised Agent Stamp.
111