All Dividends Outstanding for More Than 7 Months , Shall Be Deposited in the Investors

Application form for the release of dividends deposited in investors` trust fund
Important instructions:
Please read the following instructions carefully before filling in the attached form:

All dividends outstanding for more than 7 months , shall be deposited in the investors` trust fund
Accepting the form is subject to filling the required data and information, and providing documents relevant to the request
Required documents from the applicant:
Copy of ID card or passport for natural persons, otherwise a copy of the commercial register and affiliation certificate to the chamber of commerce for establishments and companies
Copy of a current power of attorney if the applicant is an agent for the rightful owner or his heirs attached to a copy of ID card or passport of the agent , however the submitted legal attorney should mention a valid authority to collect this money
Official letter from the legal entity authorizes the applicant to request the rightful owner`s money attached to the authorized signatory specimen listed with secretarial commercial register should be enclosed
The applicant should submit the following required documents which may prove the beneficiary`s right for the money deposited in the investors`s trust fund , this shall help in fulfilling quicker and easier procedures:
Receipt of subscription to shares or bonds
Allotment letter shares or bonds
Certificate of shares or bonds
Bill or account statement issued by the brokerage company
Any other documents that may prove the beneficiary`s right for the requested dividends
The applicant should sign a commitment in which he/she undertakes to provide the correct data and information required in the form , and further affirms to pay the received money back if it is proved that the said money was not lawfully his own ( The said commitment shall be the specimen mentioned in the form )
The applicant should submit the form - after filling in completely and getting the authorized signatures – to MDSRC . The result of the request shall be ready within 7 working days
The investors` trust fund committee has the right to request additional documents if not fully convinced with the enclosed submitted ones
For more information ,Please contact:

Capital Market Authority – Legal office
Tel:
Or
Muscat Depository & Securities Registration Company –
customer service and shareholders` affairs department
Tel: 77126071-Personal data of the Investor listed with the depository system:

شركــة مسقــط للإيـــداع وتسجيــل الأوراق الماليــة (ش.م.ع.م)

MUSCAT DEPOSITORY & SECURITIES REGISTRATION CO. (S.A.O.C)

ص.ب. 952 روي الرمز البريدي 112 سلطنة عمان ، هاتف:7717458 –فاكس:7717491

Articles (1-5) for applicant`s use
1-Personal data of the Investor listed with the depository system:
Full name of Investor according to Identity documents:------Nationality:------
Document data / No.: ------Id card Passport CR Others
Res. address / P.O. Box----- Postal cod : ---- Res. phone------Mobile -----
Work address / P.O. Box----- Postal code ----- Tel. ------Fax ------
Bank account No.: ------Bank: ------Branch: ------
Investor`s consolidated account ( If it is known for you )
Local governor: / Name: ------Tel: ------
Any relatives or friends / Name: ------Tel: ------
2- Applicant`s personal data:
Should filled only in case the applicant is an investor`s agent or is a legal entity
Full name of Investor according to Identity documents:------Nationality:------
Document data / No.: ------Id card Passport CR Others ---
Res. address / PO Box----- Postal code: ---- Res. phone ------Mobile------
Work address / P.O. Box----- Postal code ----- Tel. ------Fax ------
Local governor: / Name: ------Tel: ------
Any relatives or friends / Name: ------Tel: ------
3-Data of the dividends requested to be released: Should be filled by MDSRC staff
Serial No. /

Issuing company

/ The amount / No. of shares / For year / *Type of dividends /

Request No.

1
2
3
4
5
* Dividends includes:
1-Dividends yield2- Bond benefits3-Capital reduction4- Clearance outcome
5- Subscription excess fund6- Rejected subscription fund7- Net amount of selling shares of shareholders failed to pay
4- Release mechanism of dividendes
I`d like to get the dividends in
 Cash -if the dividends are not exceeding 50 O.R.
 Cheque - in the name of the investor only
5- Declaration affirm and commiment
I am the undersigned and the applicant herein for the investors`s trust fund declare and affirm the following:
1- It is completely known to me that the abovementioned beneficiary is the rightful owner of the dividends relevant to the request and he/she did not receive any of them before this certain time
2-I undertake and agree to return back the received dividends , if it was proved that they were not mine. Furthermore I shall pay the interest for the period I wrongfully held - any amount - using prevailing market interest rates
Authorized person or agent------
Signature and stamp------
Date -----/-----/------/ Investor`s name ------
Signature and Stamp------
Date-----/------/------

------

For official use of MDSRC
Submission date---/----/-----
We examined
the data and information presented in this certain application form and the attached documents . Furthermore, after composing the data presented to us with our records , we find that :
Data presented in this certain application form and the attached documents are adequate to establish the applicant `s right for the said dividends deposited in the investors` trust fund
Data presented in this certain application form and the attached documents are not adequate to establish the applicant `s right for the said dividends deposited in the investors` trust fund for the following reasons: ------
Authorized officer:
Employee`s name: ------
signature / Employee`s name: ------
signature:------
Date:----/---/------
For official use of financial department of Capital Market authority
( should be filled only if data included and documents attached to the application form are satisfactory )
Submission date:---/----/-----
We checked the application form data and attached documents . We confirm herein that they were satisfactory to MDSRC , so the requested dividends shall be paid in:
Cash memo No.: ------Dated:------(Valid only for requests with amount less than 50 O.R.)
 Cheque No. : ------Dated------(In the investor`s name only.)
Payment has been registered in the funds electronic records
Employee`s name: ------
Signature:

Date:

/ Reviewed by: ------
Signature:
Date

------

For official use of the investors` trust fund
This part shall be used only for unsatisfactory requests which may required the committee studying
The committee studied this certain request within its meeting held on / / and decided the following:
------
------
------
------
------
Follow up: ------ / Fund secretary`s name:
Signature : ------

Date: ----/---/------

For official use of MDSRC

Date of applicant`s application to MDSRC------/------/------
The applicant`s signature to confirm the receipt of dividends claimed ------