PDF《润利海事集团控股有限公司》

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. Please refer to the last four bullets of Effect of completing and submitting this Application Form section. 致:润利海事集团控股有限公司 保荐人 联席账簿管理人 公开发售包销商 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 「填写及递交本申 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.请参阅 「填写及递交本申请表格的效用」 一 节最后四点. ? C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C Signed by (all) applicant(s) (all joint applicants must sign): For Broker use 此栏供经纪填写 Lodged by 递交申请的经纪 由 (所有) 申请人签署 (所有联名申请人必须签署) : Broker No. 经纪号码 Broker'

s Chop 经纪印章 Date:日期: D日 M月 Y年Number of Public Offer Shares applied for (not more than 112,500,000 shares) Cheque/banker'

s cashier order number支票银行本票号码 申请公开发售股份数目 (不超过112,500,000股股份) 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) Total amount 总额 HK$ 港元 Name in English 英文姓名名称 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) 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) Names of all other joint applicants in English (if any) 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) 所有其他联名申请人的英文姓名名称 (如有) 1) 2) 1) 2) 3) 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) 及电话号码 (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 *(1) An individual must provide his Hong Kong Identity Card number or, if he does not hold a Hong Kong Identity Card, his passport number. A body corporate must provide its Hong Kong Business Registration number. Each joint applicant must provide its or his relevant number. The Hong Kong Identity Card number(s)/passport number(s)/Hong Kong Business Registration number(s) will be transferred to a third party for checking the Application Form'