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  • Lighthouse Registrars e DIVIDEND MANDATE FORM

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    zainabdoc9
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    This document contains an e-dividend mandate activation form for Cornerstone Insurance PLC shareholders. The form requests the shareholder provide their bank details like account number, bank name and branch to have dividends electronically credited to their bank account. It outlines instructions to complete all sections of the form for processing and return it to the registrar, Lighthouse Registrars Limited. Shareholders are asked to provide identification and contact information as well.

    Original Description:

    Dividend lighthouse form

    Original Title

    Lighthouse-Registrars-e-DIVIDEND-MANDATE-FORM

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    This document contains an e-dividend mandate activation form for Cornerstone Insurance PLC shareholders. The form requests the shareholder provide their bank details like account number, bank name and branch to have dividends electronically credited to their bank account. It outlines instructions to complete all sections of the form for processing and return it to the registrar, Lighthouse Registrars Limited. Shareholders are asked to provide identification and contact information as well.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    33 views1 page

    Lighthouse Registrars e DIVIDEND MANDATE FORM

    Uploaded by

    zainabdoc9
    This document contains an e-dividend mandate activation form for Cornerstone Insurance PLC shareholders. The form requests the shareholder provide their bank details like account number, bank name and branch to have dividends electronically credited to their bank account. It outlines instructions to complete all sections of the form for processing and return it to the registrar, Lighthouse Registrars Limited. Shareholders are asked to provide identification and contact information as well.

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    © All Rights Reserved
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    of 1

    Affix Current

    Passport

    ey Write your name at the back


    u of your passport photograph E-DIVIDEND MANDATE ACTIVATION FORM
    TICK NAME OF COMPANY SHAREHOLDER
    ACCOUNT NO
    Only Clearing Banks are acceptable CORNERSTONE INSURANCE PLC

    Instruction
    Please complete all section of the forms to make eligible for
    processing and return to the address below

    The Registrar,
    Lighthouse Registrars Limited
    Kingsway Building, 3rd Floor, 2/4 Davies Street
    P.O. Box 60276 Lagos Nigeria.

    I/We hereby request that henceforth, all my/our dividend


    payment due to me/us from our holdings in Cornerstone
    Insurance plc be credited to my/our bank detailed below:

    Clearing House No

    Bank Verification No

    Bank Name

    Bank Branch

    Bank Address

    Bank Account Number

    Account Opening Date

    Account Type (Tick) Current Savings


    Shareholders Account Information
    Surname First Name Other Names

    Address:
    City State Country

    Previous Address (if any)

    Mobile Telephone 1 Mobile Telephone 2


    Email Address
    Signature(s) Company’s Seal(If applicable) Joint/Company’s Signatories

    Help Desk Telephone No/Contact Centre Information for Issue resolution or clarification: +2348087901770
    Lighthouse Registrars Ltd
    Website: www.lighthousereg.com; E-mail: info@lighthousereg.com

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