Stock Transfer Form Sample
STO CK
TRANS FER
FO RM
(Above this line for Registrars only)
Company No.
Certificate lodged with the Registrar
(For com pletion by the Registrar/St ock Exch ange)
Consideration m oney
Name of
undertaking
Description of
Security
Number or am ount o f
Shares, Stock or othe r
security and, in figures
column on ly, num ber
and denom ination of
units, if any
Nam e(s) o f regist ere d
holder(s) should be
given in full: the
address should be
given where there is
only one holder.
If the transfer is not
made by th e registered
holder(s) insert also t he
name(s) a nd capacity
(e.g. , Exec utor(s) of t h e
person(s) making the
transfer
I/We hereby transfer the above sec urity out of the name(s)
aforesa i d to the person(s) named below
Stamp of selling Broker(s) or, for
transactions which are not stock
exchange transactions, of Agent(s),
if any, acting for the transferor(s)
Figures
Words
In the name ( s) of
Signature(s) of transferor(s)
1.
Units of
Date
2.
4.
3.
Full nam e(s) and full
postal address(es)
(including County or, if
applicable, Postal District
number) o f the perso n(s)
to whom the security is
transferred.
Please state title, if a ny,
or whether Mr., Mrs.. ,
Miss., or M s.
Please com plete in type
writing or in Block
Capitals.
I/We request that such entries b e made in the regist er as are n ecessary to give effect to the transfer.
Stamp or nam e and address of perso n lodging t his form
(if other than the Buying Broker(s))
Stamp of Buying Bro ker(s) (if any)
£
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