Page 3 Advertisements Column 5

Dominion, Volume 6, Issue 1593, 9 November 1912, Page 3

THE DUIMON PORTLAND CEDENT 601Pffl, LIMITED. (To be incorporated under "The Companies Act, 1903 "). .Application for Shares TO THE PROVISIONAL DIRECTORS OF THE DOMINION PORTLAND CEMENT COMPANY,-LTD.,-15S Fe.vxherston Street, Wellington. GENTLEMEN, Enclosed please find } .. , , Having paid to your Bankers j thc sum of £ - being a deposit of 2/6 per Share on application for Shares in the above-named Company, I hereby request you to allot me that number of Shares upon the terms of the Prospectus of the Company, dated 7th day of November, 1912, and of the Memorandum and Articles of Association of the Company, and I hereby agree to accept such Shares or any smaller number you may allot to me, and I further agree to pay the balance as provided by thc said Prospectus, and I request you to place my name upon the Register of Members in respect of the Shares which may be allotted to me. 1 Ordinary Signature , „ ■SB g Name (in full) „ M v $5 (Please state if Rev., Mr , Mrs., or Miss) 3 g Address ." O ~, in..n .ii. • > .... " ' ' a •' ■ ■ "■ Description J.. t ~...«..-«..«—......»....., „'-