Issuer Holdings To Chess Conversion Form: Stockbroking

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Stockbroking

ISSUER HOLDINGS TO CHESS CONVERSION form


Current Account Details
Client Account Number:


Account Holder 1

(if applicable)

Company name

Account Holder 2
Account Designation

<

Account>

(if applicable)

Conversion Details
For your conversion to be successful, your registration details on your Issuer Sponsored statements must match your registration details on your
trading account exactly, including middle name/s and address. Please ensure that if you are converting shares to a joint holding, your Issuer
Sponsored statements are in that joint holding and not single names as this constitutes a change of beneficial ownership.

q Issuer Sponsored Holding statements attached (tick if applicable)


If you have attached statements you do not need to complete the next step.
If you have not attached Issuer Sponsored Holding statements, please complete the following:
ASX Code

Security Name

Shareholder Reference No. (SRN)

Quantity

Client Agreement
I/We authorise CMC Markets Stockbroking to convert the above listed Holdings into my/our trading account. Please provide
signatures of all account holders.
Date / / 20

Client Signature(s)

Name(s) (printed)

e.g. director, officer, secretary

Account Holder 1

Account Holder 2

Title (if company)

CMC_S10_037_0613

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CMC Markets Stockbroking is the trading name of CMC Markets
Stockbroking Limited (ABN 69 081 002 851, AFSL No. 246381),
Participant of the ASX Group.

CMC Markets Stockbroking Limited


Level 13
130 Pitt Street
Sydney NSW 2000

GPO Box 5351


Sydney NSW 2001

cmcmarkets.com.au/stockbroking

Client Services 1300 360 071

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