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CSD Deposit Form Printversion

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Central Securities Depository Company of Botswana Limited

Securities Deposit Form (CSDB 3)


To be completed in BLOCK LETTERS
PARTICIPANT ID.
Securities Registration ID:

FOR INDIVIDUALS
Title: Forenames: Surname:

FOR INSTITUTIONS (Companies/Organisations/Societies/Etc)


Name:

Particulars of Security
Security Name : Security ID:
Certificate Number: Date Issued: Certificate Type: Quantity:

Total Number of Certificates: Total Numbers of Securities:

DECLARATION(To be completed by individuals)

1. I/We hereby request the deposit of the above mentioned Securities in the above mentioned Securities Account.
2. I/We hereby certify that, I am / We are the genuine holder/s of the above mentioned Securities
3. None of the deposited certificates listed above have been reported lost or destroyed to the company
4. I/We hereby declare that I/We have proper authority to sign the Deposit form and to deposit the mentioned securities into the CSDB

Signature:………………………………………………………………………………………………………………………. Date:…………………………………………….
(Applicants (Joint) / Authorised Signatory / Guardian)
CERTIFICATE OF RESOLUTION (To be completed by institutions)
I ……………………………………………………………………………………………………….......................... , hereby certify that the following resolution of the Board of Directors of
................................................................... was passed at duly convened meeting of the Board held on ……………………………………………………….. at which the
quorum was present.

It was resolved that


1. the deposit of the above mentioned Securities in the above mentioned Security Account should be effected
2. ………………………………………………………………………..is the genuine holder/s of the above mentioned Securities
3. none of the deposited certificates listed above have been reported lost or destroyed to the company
4. I/We be authorized to sign the Deposit form and to deposit the above mentioned securities into the CSDB

..................................... Certified true extract of minutes


Date

…………………………………………….
Director/Secretary
PARTICIPANT DECLARATION FOR TRANSFER SECRETARY USE ONLY
We hereby certify the validity of this transfer document and that it I/We hereby certify that I/We have verified the above information, and
has been duly executed and authenticated. i. Have authenticated the holding of the shares being deposited and verify
that these share certificates belong to the Account Holder.
Authorized Signatures……………………………………………. ii. We certify that the names of the account Holder as it appears in the
physical share register, the CSDB Account, share certificate and the
Date……………………………………… Deposit Form, refer to one and the same person.
Company Stamp
Authorized Signatures………………………………………………Date:…………………………..

Stamp

White (original) – Client Blue (Copy) – Broker Pink (Copy) – BSE Yellow (copy) - CSD

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