编辑: 没心没肺DR | 2015-08-03 |
declaration I/We agree to the terms and conditions and application procedures in this Application Form and the Prospectus. Please refer to the Effect of completing and submitting this Application Form section of this Application Form. Warning: Only one application may be made for the benefit of any person (other than an application (if any) made either through the Blue Form eIPO service via www.eipo. com.hk or on a BLUE Application Form in the capacity as a Qualifying ZhengTong Shareholder). Please refer to the last four bullets of Effect of completing and submitting this Application Form section. 致:上海东正汽车金融股份有限公司 联席保荐人 联席全球协调人 联席账簿管理人 联席牵头经办人 香港包销商 申请人声明 本人吾等同意本申请表格及招股章程的条款及条件 以及申请程序.见本申请表格 「填交本申请表格的效 用」 一节. 警告:任何人士只限作出一次为其利益而进行的认购 申请 (通过 www.eipo.com.hk 采用蓝表 eIPO 服务或以 合资格正通汽车股东身份采用蓝色申请表格提出的申 请 (如有) 除外) .请参阅 「填交本申请表格的效用」 一 节最后四点. Signed by (all) applicant(s) (all joint applicants must sign): 由 (所有) 申请人签署 (所有联名申请人必须签署) : Date: 日期: D 日M月Y年Number of Hong Kong Offer Shares applied for (not more than 26,667,000 H Shares) 申请香港发售股份数目 (不超过26,667,000股H股股份) Total amount 总额 HK$ 港元 Name in English (in BLOCK letters) 英文姓名名称 (正楷) Family name or company name 姓氏或公司名称 Forename(s) 名字 Name in Chinese 中文姓名名称 Family name or company name 姓氏或公司名称 Forename(s) 名字 Occupation in English 职业 (以英文填写) Names of all other joint applicants in English (if any, in BLOCK letters) 所有其他联名申请人的英文姓名名称 (如有,正楷) 1) 2) 3) Hong Kong address in English and telephone no. (joint applicants should give the address and the telephone number of first named applicant only)香港地址 (以英文填写) 和电话号码 (联名申请人只须填写排名首位申请人的地址及电话号码) Telephone No. 电话号码 For Nominees: You will be treated as applying for your own benefit if you do not complete this section. Please provide an account number or identification code for each (joint) beneficial owner. 由代名人递交:代名人若不填写本节,是项认购申请 将视作为 阁下利益提出.请填写每名 (联名) 实益拥有人的 账户号码或识别编码. ADDRESS LABEL 地址标贴 (Your name(s) and address in Hong Kong in BLOCK letters 请用英文正楷填写姓名名称 及香港地址) For Internal use 此栏供内部使用 For Broker use 此栏供经纪填写 Lodged by递交申请的经纪 (Broker No. 经纪号码) Broker'
s Chop经纪印章 Cheque/banker'
s cashier order number 支票银行本票号码 Name of bank on which cheque/Banker'
s cashier order is drawn (see How to make your application section) 兑现支票 银行本票的银行名称 (见 「申请手续」 一节) Hong Kong Identity Card No./Passport No./Hong Kong Business Registration No.* (Please delete as appropriate) 香港身份证号码 护照号码香港商业登记号码* (请删除不适用者) Hong Kong Identity Card No./Passport No./Hong Kong Business Registration No. of all other joint applicants* (Please delete as appropriate) 所有其他联名申请人的香港身份证号码护照号 码香港商业登记号码* (请删除不适用者) 1) 2) 3) THIS BOX MUST BE DULY COMPLETED 必须填妥此栏 Participant I.D. of the CCASS Investor Participant or designated CCASS Participant 中央结算系统投资者户口持有人或指定的中 央结算系统参与者的参与者编号 For designated CCASS Participant or Corporate CCASS Investor Participant, please also affix the company chop bearing its company name指定的中央结算系统参与者或中央结算系统公司投资者户 口持有人,请加盖显示公司名称的公司印鉴 (See paragraph