Listing Rules and Guidance: Contents
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Form D Marketing Statement
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A separate marketing statement in this form must be completed by the lead broker, any distributor(s) and every Exchange Participant with whom or through whom the securities are placed in the following circumstances:-
* see Note 3 at the end of this form
|(To be completed by lead broker only) (Note 3)||Amount or Number of securities||% of Placing|
|Distributors (As in A7)||_____________||_______(1)|
|Total (As in A3)||_____________||____100_____|
|Number of By the undersigned to:||Number of holders||Amount or Number of securities||% of Placing|
|(2) Existing or past employees of the issuer||_________||_________||_________|
|(3) Discretionary managed portfolios||_________||_________||_________|
|(4) Other Exchange Participants (see also C12 below) (Note 5)||_________||_________||_________|
|(5) Retained by the undersigned||_________||
(As in A4)
|(1) Offered to the public||N/A||_________||_________|
|(2) Applied for by the public||_________||_________||N/A|
|(3) Basis of allocation, where oversubscribed||_____________________________|
|By the undersigned to other Exchange Participants (Note 5)||Name of Exchange Participant||Amount or Number of securities||% of Placing|
|As in C.10(4)||__________||__________|
I hereby certify that to the best of my knowledge and belief, none of the securities placed by me have been placed with the directors of the issuer or their close associates or any existing shareholder of the issuer or any nominee of any of the foregoing.
Name and position held _______________________________________________________________
Name of company ___________________________________________________________________