Você está na página 1de 2

DEBENTURE

Debenture Application Form


ROSE BOWL PLC (the Company) APPLICATION FORM FOR SEVEN YEAR DEBENTURES 2010 - 2016 THIS FORM MUST BE RETURNED TO THE DEBENTURE ADMINISTRATOR, ROSE BOWL PLC, BOTLEY ROAD, WEST END, SOUTHAMPTON, HAMPSHIRE, SO30 3XH NO LATER THAN 30th NOVEMBER 2009 Name of Applicant: (NB: If Applicant is a Company or other body corporate, partnership, club or organisation please include full registered name) Address of Applicant: Post Code: e-mail: Date of birth: Company Registration Number (if applicable): Name of the Corporate Representative (if applicable): Nominated Bank Account Name*: Bank: Number of Platinum Debentures applied for: Number: at 6,000 [insert number] Number of Gold Debentures applied for: at 5,000 [insert number] Number of Silver Debentures applied for: at 2,500 [insert number] [insert amount] [insert amount] [insert amount] [insert total] If not all the Debentures I have applied for are available, I conrm that I would like to replace /all* of my applications for Platinum Debentures/Gold Debentures* with Gold Debentures/Silver Debentures* (*Delete as applicable). Preference for the location of the Designated Seat(s) in respect of the Debenture(s) applied for (*Delete as applicable) [Not applicable to Single Debentures]: Front half of Relevant Debenture Seating Area*/Rear half of Relevant Debenture Seating Area* * The Nominated Bank Account must be in the name of the Applicant (either singly or jointly) in the case of individual Applicants, or in the name of the company, partnership, club or organisation (as appropriate) in the case of other Applicants. FOR OFFICE USE ONLY Applied for Allotted Certicate No(s) Date received: Amount paid: Ticket to be used Block Row Seat(s) Box A Sort Code: Daytime Tel: Mobile Tel:

1 I have read and understood the Offer Terms relating to the issue of Debentures by the Company dated 8 September 2009 and I hereby apply for and request you to allocate to me the number of Debentures specied above. I agree to accept the same or any less number of Debentures as may be allocated in accordance with such Offer Terms and I authorise you to place my name upon the Debenture as the Registered Holder in respect of the Debentures so allotted. 2 I enclose a cheque payable to Rose Bowl plc - Debenture Account for the full amount stated at Box A above. 3 I understand that the sums payable in respect of the issue of Debentures is non-returnable if and to the extent my application is accepted by the Company, save for (a) the redemption of the Debentures as set out in the Offer Terms and (b) a partial refund if my preferred Debentures are not available and my election to substitute them with alternative Debentures is successful. 4 I hereby authorise you to: 4.1 send me the Debenture allocation letter and the Certicate by post to the address set out above at my risk; and 4.2 repay any of my application monies in respect of either (a) a rejection of my application (in whole or in part) or (b) a partial refund in accordance with paragraph 3(b) above either directly to my Nominated Bank Account or by cheque posted to the address set out above at my risk. 5 I conrm that the Offer Terms will (upon my application to subscribe for Debentures being accepted by the Company) constitute the entire agreement between myself and the Company in respect of the issue of such Debentures. I acknowledge and agree that, in applying to subscribe for Debentures, I have not relied on, and shall have no remedy in respect of, any statement (whether written or oral), representation, warranty or understanding (whether negligently or innocently made) of any person whatsoever (including without limitation, the Company, its ofcers, employees and agents) other than as expressly set out in the Offer Document. I understand, however, that this paragraph 5 shall not operate to limit or exclude any liability for fraud. 6 I conrm that I am aged 18 or over (in the case of individual applicants). 7 I understand that the Company reserves the right to request such verication of identity and/or other information or documents as it may determine so as to comply with any anti-money laundering requirements, and that the Company reserves the right to reject any application if any such information is not supplied. Signature of Applicant

Date

NOTES: Applications by individuals should be signed by the individual. Applications by companies, partnerships, limited liability partnerships, clubs or organisations should be signed by their Corporate Representative. In order to reduce the likelihood of delays or of applications being terminated, Applicants for Debentures should ideally make payment by means of a cheque drawn on the Applicants account. If this is not practicable and an Applicant uses a cheque drawn by a third party or a building society cheque or bankers draft, the Applicant should: write the name and address and, in the case of individuals, date of birth of the Applicant on the back of the cheque, building society cheque or bankers draft; if payment is made by building society cheque (not being a cheque drawn on an account of the Applicant) or bankers draft, ask the building society or bank to endorse on the cheque or bankers draft the name and account number of the person whose building society or bank account is being debited and add its stamp; and if delivering an Application Form by hand, ensure that he has with him evidence of identity bearing his photograph (e.g. a passport). The personal data which you provide on this Application Form will be used by the Company (or its agents) for the purposes of administrating your application and, in the event your application is successful, your rights as a Debenture Holder. By submitting this form I understand that: the Company and/or the England and Wales Cricket Board Limited (ECB) will use my information to administer my order and create an individual prole for me. I am consenting to the Company and/or the ECB using my information to contact me by phone, post, email and SMS to tell me about offers, products, services and initiatives available unless I have indicated otherwise by ticking the boxes below Phone [ ] Post [ ] Email [ ] SMS [ ]

I am consenting to the Company and/or the ECB passing my contact details to their commercial partners* so that they can tell me by phone, post, email and SMS about offers and initiatives available to me unless I have indicated otherwise by ticking this box [ ] * A full list of commercial partners is available at www.rosebowlplc.com for the Company partners and www.ecb.co.uk for ECB partners.

DEBENTURE

THIS FORM MUST BE RETURNED TO THE DEBENTURE ADMINISTRATOR, ROSE BOWL PLC, BOTLEY ROAD, WEST END, SOUTHAMPTON, HAMPSHIRE, SO30 3XH NO LATER THAN 30 NOVEMBER 2009

Você também pode gostar