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Current Passport EDC REGISTRARS LIMIITED


(To be stamped by Bankers)

Please write your name at the


E-DIVIDEND ACTIVATION FORM
back of your passport
photograph

Instruction:
Only Clearing Banks are acceptable
Please complete all sections of this form to make it eligible for Kindly tick & quote your shareholder account no.
processing and return to the address below in the box below:
THE REGISTRAR
EDC REGISTRARS LIMITED RC 475195 Tick Name of Company Shareholder
154 IKORODU ROAD, ONIPANU, LAGOS
I/We hereby request that henceforth, all my/our Dividend Payment(s)
Number
due to me/us from my/our holdings in all the companies ticked at the
right hand column be credited directly to my/our bank detailed below: Adswitch Plc
Bank Verification Number
Afromedia Plc

Courteville Bus. Solutions Plc


Bank Name
Cutix Plc
Bank Branch/Address Dangote Flour Mills Plc

Bank Account Number Imo State Government Bond

Plateau State Government Bond


Account Opening Date
Resourcery Plc
Shareholder Account Information
Surname/Company name First name Other Names

Address:

City State Country

Previous Address (If any)

CHN (If any)

Mobile Telephone (1) Tel (2)

E-mail Address
Signature(s) Company Seal (if applicable)

Joint/Company’s Signatories Authorised Signature of Bank/Stamp

For enquiries, please call 01-4538671-4 or send email to


EdcRegComplaints@ecobank.com

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