Form D Marketing Statement

Form D

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:-

(1) a placing of equity securities by or on behalf of a new applicant
(2) a placing of equity securities of a class new to listing by or on behalf of a listed issuer

The requirements of Chapter 7 and Appendix 6 and the accompanying Notes should be read before completing this statement.

1. Name of issuer/vendor _________________________________________________________
2. Description of security _________________________________________________________
3. Total amount or number of securities being placed _________________________________
4. Total amount or number of securities being placed by the undersigned

*5. Net price to the issuer/vendor (Note 4) ____________________________________________
*6. Name of lead broker ___________________________________________________________
*7. Name(s) of distributor(s) (if appropriate)
1. ________________________________________
2. ________________________________________
3. ________________________________________
4. ________________________________________
*8. Name(s) of the persons(s) or firm(s) from whom the undersigned obtained the securities to be placed by the undersigned ____________________________________________________

* 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)
_____________ _______(2)
_____________ _______(3)
_____________ _______(4)
General Public _____________ _________
Total                  (As in A3) _____________ ____100_____

Number of By the undersigned to: Number of holders Amount or Number of securities % of Placing
(1) Clients _________ _________ _________
(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)
(6) TOTAL _________ _________ _________
11. By the lead broker to the general public:

(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.

Signed ____________________________________________________________________________

Name and position held _______________________________________________________________

Name of company ___________________________________________________________________

Date ______________________________________________________________________________


1. Marketing statements will only be accepted when the required details are typed on the statement.
2. A marketing statement in this form must be completed by each of the distributors named in paragraph 9 and each of the other Exchange Participants (if any) named in paragraph 12 and sent directly to the Exchange by that person.
3. Paragraphs 5–8 of GENERAL and paragraph 9 of SUMMARY OF DISTRIBUTION need be completed by the lead broker only.
4. In paragraph 5, the net price should represent the effective issue price to the issuer or vendor.
5. In completing paragraphs 10(4) and 12, the lead broker may exclude the distributors named by him in paragraph 9.
6. As soon as practicable after the hearing of the application by the Exchange but before dealings commence, a list setting out the names, addresses and identity card or passport numbers (where individuals) and the names, addresses and registration numbers (where companies) of all placees, the names and addresses of the beneficial owners (in the case of nominee companies) and the amounts taken up by each placee must be lodged with the Exchange.