7/28/2019 IPO Full (all in one).docx
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Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... ............................................................................................................................................................................................................ ...................Bank................................................................................. Br
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MOST. SHAMSUN NAHAR
Father's/Husbands Name: LATE SHAMSUL HOQ
Mothers Name: SADIRON NESA
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any): 01748566325
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No : 100024188
Name of the Bank : SONALI BANK LTD Branch : KAMLAPUR RAILWAY STATION
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MOST. SHAMSUN NAHAR Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the applicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MOST. SHAMSUN NAHAR being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 4 0 8 5 5
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
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Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MOST. SHAMSUN NAHAR
Father's/Husbands Name: LATE SHAMSUL HOQ
Mothers Name: SADIRON NESA
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any): 01748566325
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No : 100024188
Name of the Bank : SONALI BANK LTD Branch : KAMLAPUR RAILWAY STATION
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MOST. SHAMSUN NAHAR Signature :
(ii) Name (in Block Letters) MST. MORIUM BEGUM Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MOST. SHAMSUN NAHAR&MST. MORIUM BEGUM being the application money for 2nos. of ordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 4 0 9 1 3
Name: MST. MORIUM BEGUM
Father's/Husbands Name: MD. SHARIF MIAH
Mothers Name : LATE SAFIA BEGUM
Postal Address : _DO_
Occupation : HOUSE WIFE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
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Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. SHAHJALAL SAGOR
Father's/Husbands Name: MD. ABDUL KAIYUM
Mothers Name: RINA BEGUM
Postal Address: 166, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: STUDENT Nationality: Bangladeshi Phone (if any) : 01717824691
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No : 118. 105. 62161
Name of the Bank : DUTCH BANGLA BANK LTD. Branch : ISLAMPUR
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. SHAHJALAL SAGOR Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the applicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. SHAHJALAL SAGOR being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 4 0 9 1 5
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
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Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. SHAHJALAL SAGOR
Father's/Husbands Name: MD. ABDUL KAIYUM
Mothers Name: RINA BEGUM
Postal Address: 166, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: STUDENT Nationality: Bangladeshi Phone (if any) : 01717824691
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 118. 105. 62161
Name of the Bank : DUTCH BANGLA BANK LTD. Branch : ISLAMPUR
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. SHAHJALAL SAGOR Signature :
(ii) Name (in Block Letters) MD. SHAHJAHAN SIRAJI Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. SHAHJALAL SAGOR&MD. SHAHJAHAN SIRAJI being the application money for 200of ordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 4 0 9 1 5
Name : MD. SHAHJAHAN SIRAJI
Father's/Husbands Name : ABDUR ROB HOWLADER
Mothers Name : ACHIA KHATUN
Postal Address : _DO_
Occupation : SERVICE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
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Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. NAZIR HOSSAIN
Father's/Husbands Name: LATE ANSAR ALI
Mothers Name: LATE SOBURON NESA
Postal Address: 166, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: SERVICE Nationality: Bangladeshi Phone (if any) : 01911384742
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 10002378-4
Name of the Bank : SONALI BANK LTD. Branch : KAMLAPUR ICD
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. NAZIR HOSSAIN Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicantsbanker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. NAZIR HOSSAIN being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 5 3 7 3 0
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
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Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... ........................................................................................................................................................................................................... ...................Bank................................................................................. Br
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. NAZIR HOSSAIN
Father's/Husbands Name: LATE ANSAR ALI
Mothers Name: LATE SOBURON NESA
Postal Address: 166, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: SERVICE Nationality: Bangladeshi Phone (if any) : 01911384742
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 10002378-4
Name of the Bank : SONALI BANK LTD. Branch : KAMLAPUR ICD
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. NAZIR HOSSAIN Signature :
(ii) Name (in Block Letters) MST. NAZMA BEGUM Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, ofthe applicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. NAZIR HOSSAIN & MST. NAZMA BEGUM being the application money for 200of ordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 5 3 7 3 1
Name: MST. NAZMA BEGUM
Father's/Husbands Name: MD. ANSAR ALI
Mothers Name: SOBURON NESA
Postal Address: _DO_
Occupation : HOUSE WIFE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
7/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated................................................................................................................................................................................................................ ...................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. SAKIL HOSSAIN
Father's/Husbands Name: LATE SHAMSUL HOQ
Mothers Name: SAMSUN NAHAR
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: SERVICE Nationality: Bangladeshi Phone (if any) : 01926670782
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 102. 101. 0123510
Name of the Bank : EASTERN BANK LTD. Branch : MOTIJHEEL
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. SAKIL HOSSAIN Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. SAKIL HOSSAIN being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 5 3 7 3 2
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
8/24
Interestedpersons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(Tobe sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Article
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated...................................................................................................................................................................................................................................Bank................................................................................. B
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. SAKIL HOSSAIN
Father's/Husbands Name: LATE SHAMSUL HOQ
Mothers Name: SAMSUN NAHAR
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: SERVICE Nationality: Bangladeshi Phone (if any) : 01926670782
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 102. 101. 0123510
Name of the Bank : EASTERN BANK LTD. Branch : MOTIJHEEL
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. SAKIL HOSSAIN Signature :
(ii) Name (in Block Letters) MD. MANIK MIAH Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. SAKIL HOSSAIN & MD. MANIK MIAH being the application money for 200 noordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 5 3 7 3 3
Name : MD. MANIK MIAH
Father's/Husbands Name : LATE TAHER MIAH
Mothers Name : MST. SALEHA BANU
Postal Address : _DO_
Occupation : SERVICE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
9/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... ...............................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. SAJIB HOSSAIN
Father's/Husbands Name: LATE MD. SHAMSUL HOQ
Mothers Name: SAMSUN NAHAR
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: BUSINESS Nationality: Bangladeshi Phone (if any) : 01923291572
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 100019826
Name of the Bank : SONALI BANK LTD. Branch : KAMLAPUR ICD
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. SAJIB HOSSAIN Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the applicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. SAJIB HOSSAIN being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 4 0 8 5 4
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
10/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. SAJIB HOSSAIN
Father's/Husbands Name: LATE MD. SHAMSUL HOQ
Mothers Name: SAMSUN NAHAR
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: BUSINESS Nationality: Bangladeshi Phone (if any) : 01923291572
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 100019826
Name of the Bank : SONALI BANK LTD. Branch : KAMLAPUR ICD
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. SAJIB HOSSAIN Signature :
(ii) Name (in Block Letters) MD. JAHANGIR HOSSAIN Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. SAJIB HOSSAIN & MD. JAHANGIR HOSSAIN being the application money for 200of ordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 5 3 7 3 6
Name: MD. JAHANGIR HOSSAIN
Father's/Husbands Name: LATE KALA MIA
Mothers Name : LATE JOYNOB BIBI
Postal Address : _DO_
Occupation : SERVICE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
11/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY AFFECTED SMALL INVESTOR(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... ............................................................................................................................................................................................................ ...................Bank................................................................................. Br
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: MD. ANWAR HOSSAIN
Father's/Husbands Name: LATE MD. TURAB ALI
Mothers Name: MRS. SALEMAN KHATUN
Postal Address: M/S. MODHUMOTI ENTERPRISE, 44, DILKHUSHA C/A(3RD FLOOR), DHAKA, 1000
Occupation: SERVICE Nationality: Bangladeshi Phone (if any) : 01912578826
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 105. 101. 274719
Name of the Bank : DUTCH BANGLA BANK LTD. Branch : FOREIGN EXCHANGE
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) MD. ANWAR HOSSAIN Signature :
(ii) Name (in Block Letters) MST. ABEDA SULTANA Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the applicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms MD. ANWAR HOSSAIN & MST. ABEDA SULTANA being the application money for 200of ordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 1 1 8 8 6 5
Name : MST. ABEDA SULTANA
Father's/Husbands Name : MD. ANWAR HOSSAIN
Mothers Name : SURAYA KHATUN
Postal Address : _DO_
Occupation : SERVICE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
12/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: RAHANA AKTER
Father's/Husbands Name: MD. KHALILUR RAHMAN
Mothers Name: RAZIA KHATUN
Postal Address: 67/4 NORTH GOLAPBAG DHAKA, 1203
Occupation: STUDENT Nationality: Bangladeshi Phone (if any) : 01923291572
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 10011332
Name of the Bank : JANATA BANK LTD. Branch : WAPDA
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) RAHANA AKTER Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuershall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms RAHANA AKTER being the application money for 200 nos. of ordinary sharBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 2 7 9 6 8
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
13/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... ........................................................................................................................................................................................................... ...................Bank................................................................................. Br
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: RAHANA AKTER
Father's/Husbands Name: MD. KHALILUR RAHMAN
Mothers Name: RAZIA KHATUN
Postal Address: 67/4 NORTH GOLAPBAG DHAKA, 1203
Occupation: STUDENT Nationality: Bangladeshi Phone (if any) : 01923291572
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 10011332
Name of the Bank : JANATA BANK LTD. Branch : WAPDA
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) RAHANA AKTER Signature :
(ii) Name (in Block Letters) SHILA AKTER Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms RAHANA AKTER & SHILA AKTER being the application money for 200 noordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 2 7 9 6 9
Name: SHILA AKTER
Father's/Husbands Name: ALI AKBER MIA
Mothers Name: ASMA BEGUM
Postal Address: _DO_
Occupation : HOUSE WIFE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
14/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated................................................................................................................................................................................................................ ...................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: NIRJONA IRIN
Father's/Husbands Name: MD. SAKIL HOSSAIN
Mothers Name: RABEYA
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any) : 01674942296
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 100024451
Name of the Bank : SONALI BANK LTD. Branch : K. RAIL WAYSTATION
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) NIRJONA IRIN Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms NIRJONA IRIN being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 2 7 9 7 2
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
15/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... ...............................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: NIRJONA IRIN
Father's/Husbands Name: MD. SAKIL HOSSAIN
Mothers Name: RABEYA
Postal Address: 47, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any) : 01674942296
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 100024451
Name of the Bank : SONALI BANK LTD. Branch : K. RAILWAY STATION
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) NIRJONA IRIN Signature :
(ii) Name (in Block Letters) MST. BEAUTY BEGUM Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicantsbanker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms NIRJONA IRIN & MST. BEAUTY BEGUM being the application money for 200of ordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 2 7 9 6 7
Name: MST. BEAUTY BEGUM
Father's/Husbands Name: ABDUL KAIUM
Mothers Name: JELATUN BEGUM
Postal Address : _DO_
Occupation : HOUSE WIFE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
16/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated................................................................................................................................................................................................................ ...................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: NURNAHAR BEGUM
Father's/Husbands Name: MD. YOUSUF ALAM
Mothers Name: SADIRON NESA
Postal Address: 166, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any) : 01939298047
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 24180
Name of the Bank : ISLAMI BANK BD. LTD. Branch : F. EX. CORP.
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) NURNAHAR BEGUM Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms NURNAHAR BEGUM being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 3 6 5 3 2
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
17/24
Interestedpersons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(Tobe sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Article
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated...................................................................................................................................................................................................................................Bank................................................................................. B
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: HASNA HENA
Father's/Husbands Name: ABDUL MALEK
Mothers Name: KHOSHNAHAR BEGUM
Postal Address: 168, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any) : 01918111564
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 24976
Name of the Bank : ISLAMI BANK BD. LTD. Branch : F. EX. CORP.
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) HASNA HENA Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the applicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms HASNA HENA being the application money for 200 nos. of ordinary shareBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 3 7 0 6 0
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
18/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: HASNA HENA
Father's/Husbands Name: ABDUL MALEK
Mothers Name: KHOSHNAHAR BEGUM
Postal Address: 168, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any) : 01918111564
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 24976
Name of the Bank : ISLAMI BANK BD. LTD. Branch : F. EX. CORP.
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) HASNA HENA Signature :
(ii) Name (in Block Letters) ABDUL MALEK Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms HASNA HENA & ABDUL MALEK being the application money for 200 noordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 3 7 0 7 1
Name: ABDUL MALEK
Father's/Husbands Name: LATE ABDUL SATTAR
Mothers Name: LATE AZMERI BEGUM
Postal Address : _DO_
Occupation : BUSINESS Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
19/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... ............................................................................................................................................................................................................ ...................Bank................................................................................. Br
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: NURJAHAN AKTER
Father's/Husbands Name: SULTAN AHAMED
Mothers Name: LATE SOBURON NESA
Postal Address: 166, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any) : 01817523730
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 12100040048
Name of the Bank : SHAHJALAL ISLAMI BANK LTD. Branch : DHAKA MAIN
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) NURJAHAN AKTER Signature :
(ii) Name (in Block Letters) Signature :
* In case of deposit into the applicantsbank account, the applicant will bear the applicable service charge, if any, of the applicants banker, and the issuer shall simultaneously issue aof intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms NURJAHAN AKTER being the application money for 200 nos. of ordinary sharBengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 3 7 0 8 1
Name :
Father's/Husbands Name :
Mothers Name :
Postal Address :
Occupation : Nationality: Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
20/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated..................................................................................................................................................................................................................................Bank................................................................................. Bran
3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5.Particulars of Applicant(s):
a) Sole/First Applicant:
Name: NURJAHAN AKTER
Father's/Husbands Name: SULTAN AHAMED
Mothers Name: LATE SOBURON NESA
Postal Address: 166, SOUTH KAMLAPUR, DHAKA, 1217
Occupation: HOUSE WIFE Nationality: Bangladeshi Phone (if any) : 01817523730
For Refund Warrant: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-schedul
bank. To avoid this complication, applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: 1/we want refund through Bank Account Hand Delivery / Courier ( put tick mark in which refund will be madThe applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
Applicant's Bank A/C No: 12100040048
Name of the Bank : SHAHJALAL ISLAMI BANK LTD. Branch : DHAKA MAIN
b) Second Applicant:
6. I/we hereby declare that I/we have read the Prospectus of
Bengal Windsor Thermoplastics Limited and have willi
subscribed for 200 No. of Ordinary Shares of Tk 25/- each at par.7. Specimen Signature(s):
(i) Name (in Block Letters) NURJAHAN AKTER Signature :
(ii) Name (in Block Letters) SULTAN AHAMED Signature :* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the a pplicants banker, and the issuer shall simultaneously issue a
of intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) 5000/- (in word: Five Thousand ) only Mr./Mrs./Ms NURJAHAN AKTER & SULTAN AHAMED being the application money for 200of ordinary shares of Bengal Windsor Thermoplastics Limited.
Authorized SignaBankers SL. No. Seal &Date (Name & Designa
1 2 0 3 5 7 0 0 4 6 3 7 0 8 2
Name: SULTAN AHAMED
Father's/Husbands Name: LATE ABUL HASHEM
Mothers Name: KHURSIA BEGUM
Postal Address : _DO_
Occupation : SERVICE Nationality: Bangladeshi Phone (if any) :
Bankers SI. No.
7/28/2019 IPO Full (all in one).docx
21/24
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
BENGAL WINDSOR THERMOPLASTICS LIMITEDAPPLICATION FORM
APPLICATION FOR SHARES BY AFFECTED SMALL INVESTOR(S)
(To be sent directly to the Companys Corporate Office)Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing DirectorBengal Windsor Thermoplastics LimitedBengal House, 75 Gulshan Avenue, Gulshan 1, Dhaka 1212, Bangladesh
Dear Sir,I/we apply for and request you to allot me/us the 200 numbers of Shares and I/we agree to accept the same or any smaller number that maallotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the Memorandum and Articl
Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of the Company and deposit the ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed (Account Payee only) cheque in respect of Application money refundable to me/us by post/courier at my/our risk to the first applicant's address stated below:
1. No. of Ordinary Shares 200 of Tk 25/- each at par.2. Total subscription money of the amount of Tk. (in figures) 5000/- Taka (in words) Five Thousand only
Deposited vide Cash/Cheque/Draft/Pay Order No ......................................................................dated.... .........................................................................................
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