Affix

Current
Passport
(To be stamped by Bankers)
Write your name at the back of E-DIVIDEND MANDATE ACTIVATION FORM
your passport photograph

TICK COMPANY NAME SHAREHOLDERS

ACCOUNT NO.
Abplast Products PLC

Only Clearing Banks are acceptable Aluminium Extrusion PLC

Instruction Cashew Nut Processing Industries

PLC
Please complete all section of this form to make it eligible for processing and return to the Chellarams PLC
address below
Christlieb PLC
The Registrar
GTL REGISTRARS LIMITED DANA Group Of Companies Plc
Series Tranche 1 & 2
No 2, Burma Road DN Meyer PLC
Apapa
Lagos DN Tyre & Rubber PLC

I\We hereby request that henceforth, all my\our Dividend Payment(s) due to Ecobank Transnational
Incorporated
me\us from my\our holdings in all the companies ticked at the right hand column
Ekiti State Bond Tranche 1 & 2
be credited directly to my \ our bank detailed below:
EKOCORP PLC
Bank Verification Number
Eterna Oil PLC

First Aluminium PLC

Bank Name
General Telecoms PLC

Bank Account Number GlaxoSmithKline Nigeria PLC

Global Biofuels Nigeria Limited

Account Opening Date Great Nigeria Insurance PLC

Ikeja Hotels PLC

Shareholder Account Information
Impresit Bakolori PLC
Surname/Company Name First Name Other Name
Industrial &General Insurance PLC

IPWA PLC

Address John Holts PLC

Julius Berger Nigeria PLC

Kajola Integrated &Investment

Company PLC
Lennards Nigeria PLC

Local Contractors Receivables

City State Country Bond Tranche 1,2 & 3
Mobil Oil Nigeria PLC

Nestle Nigeria PLC

Previous Address (If any) Nigeria Cement Company PLC

Nigeria Reinsurance

Nigerian Enamelware Company

PLC
Nigerian Lamps Industries
CSCS Clearing House Number
Nigerian Wire & Cable PLC

Okitipupa Oil Palm PLC

*Mobil Number 1 *Mobil Number 2 Oluwa Glass COMPANY

Seven-Up Bottling Company PLC

The Tourist Company of Nigeria

Email Address PLC
Tripple Gee & Company PLC

UBA Fixed N20 Billion Bond Series

1 Bond
Shareholder’s Signature Company Seal (If applicable) UBN Property Limited

Unilever Nigeria PLC

Union Assurance Company Limited

(NOW Ensure Insurance)
Union Bank of Nigeria PLC

Joint/Companies Signatures Union Homes REITS

Union Homes Savings & Loans PLC

Help Desk Telephone No/Contact Centre
University Press PLC
Information for Issue resolution or clarification:
234-(0)1-2917747, +234-(0)1-2793160-2. WEMA Bank PLC

GTL Registrars Limited

Website: www.gtlregistrars.com. Email info@gtlregistrars.com