Companies. (Ch. 31. No. 1.
No. 63. (Rule 101.)
Notice of Return to Contributories.
[Please bring this Notice with you.)

Payable Vouchers* are cancelled at the expiration of three months from date of

ssue, but will be re-issued free of charge on application within six months from
month of issue.

_A fee of twenty-four cents when the return does not exceed four dollars and
vighty cents and sixty cents when the return exceeds four dollars and cighty cents, is

chargeable on the RE-Issvt of cach Vayable Voucher® after six months from the date
of issue.

LJ itle.|
Return of § per share.
! Address. |
| Date.]
Notice is hereby given that a return of per share has been
declared in this matter, and that the same may be received at my office, as above,
on the day of 19 or on anv subsequent day, except

Saturday, between the hours of

Upon applying for payment this notice must be produced entire, together with
the share certificate. If you do not attend personally you must forward the share
certificate and fill up and sign the subjoined Forins of Receiptand Authority fo Deliver,
when a VPayablte Voucher* in your favour will be delivered in accordance with the
Attthority.

(Signed)
Liquidator.

Notre. The receipt should be signed by the contributory personally, or in the case
of joint contributories by each, and in the case of a limited company by an otlicer
of the company, so described.

Rr
No. 19
Received of the in this matter the sum of dollars cents,
being the amount payable to in respect of the return of per
share held by in this company.

‘ontributory’ Signature.

AUTUORITY FOR DELIVERY (a).
Str,
Please deliver (b) fo me/us by post, at my/our risk or to the bearer Mr.
voucher® for the return payable to me/us in this matter.
Contribute
Vo the (Official Receiver and! Liquidator.
Date 19

663

* In cases in
which the
payments
are made by
cheque
substitute

** cheques "
or “ cheque.”

(a) Note.—
This is an
authority
only to
deliver the
Payable
Voucher, not
fo make it
payable to
another
person.

(b) Strike
out words
inapplicable.
If not to be
sent by post
strike out
the words in
italics and
insert the
name of the
person who
is to reccive
the voucher.