2009 Annual Report and Financial Statements - UBA Plc

e-Dividend mandate form
Dear Shareholder,
We are pleased to advise you of our new e-dividend service, which enables direct credit of your dividend to your bank account regardless of
the bank or account type, i.e. Current/Savings Accounts. Should you prefer this service, please fi ll in the spaces provided below and return to us.
Please use the name(s) in which your shares are held, with the signature on your Application or Transfer Form.
Thank you.
The Managing Director/Registrar
UBA Registrars Limited
Raymond House (3 and 4 Floor)
97/105 Broad Street
Lagos
Tel: 01-46 12373-6; 8752604
Company where share is held:
Please take this as authority to credit my/our under-mentioned account with any dividend payment(s) due on my/our Shareholding in the
aforementioned company(ies), the particulars of which are stated below from the date hereof:
Shareholder’s Name*:
Shareholder’s Account No (if known):
Address*:
(Surname) (Other Names)
Mobile Number*:
Fax Number: e-mail Address*:
Bank Name*: Branch*:
Bank Account No*: Account Type*:
Dated this* day of 20
Registrars
Bank Stamp & Authorised Signatories Shareholder(s) Signatories
Note:
The provision of information on your Bank, Name, Bank Account No E-mail address and Mobile number are very important to enable us to
process your mandate.
We wish to inform shareholders in the North and South-south region of the country to please contact our Abuja or Port-Harcourt Liaison Offi ce
for all enquiries concerning your shareholding in all our client companies (see addresses below).
Lagos Abuja Port-Harcourt
3rd and 4th Floors, Raymond House 11 Lafi a Close Plot 137, Oluobasanjo Road
97/105 Broad Street Area 8, Garki, Abuja (2nd fl oor), Port-Harcourt
PMB 12649, Marina 09-8701645 Rivers State