Submit an appendix L to the company I believe, I will be...

Submit an appendix L to the company I believe, I will be emailing them for instructions if/ when I exercise mine.

L
STANDARD EXERCISE FORM – OPTIONS
(To enable option holders to apply for Securities on exercise of a company issued option)
To:
Exercise Date (if Applicable)
____ / ____ / ____
(Name of Issuer)
* I / We hereby exercise * my / our option to apply for:

(Number in figures) (Number in words)
Securities in the above mentioned Issuer and
(Description of Security)
* I / We enclose payment of ___________.___ covering each Security applied for.
(Amount per Security)
A Cheque for the total payment of $A _____________ . _____ is attached.
* I / We request you allot such securities to * me/us and agree to accept them as subject to the Company’s
Memorandum and Constitution.
Holder Identification Number (HIN):
(HIN):
Registration Details of Option Holder:
This application may be signed by:
- the holder(s) of the Securities; or
- a person appointed by a power of attorney from the holder (if signed under power of attorney, the
attorney is to declare that he/she has no notice of revocation of the power of attorney); or
- companies, who must sign under seal.

(Print Name) (Signature)

(Print Name) (Signature)

____ / ____ / ____
(Date )
Company Seal
(if Applicable)
Important Note:
Please read the conditions relating to the issue and exercise of these options
carefully.
* Delete the item not applicable
Lodging Participant’s Stamp (if Applicable)
This proforma document is an example only. Participants should contact the Share Registry to ensure the correct form is used.
ASX Settlement Pty Limited takes no responsibility in relation to the use of this proforma document.