Page 2 of 3 WST1004 (12/18)
SECTION A - SELLER(S)/TRANSFEROR(S) DETAILS
1. ACCOUNT REGISTRATION NAME OF SELLER: The given names and surname of
the seller(s).
Deceased estates should read “(the full names of the executors) as Executors of
the estate of (name of deceased shareholder)”.
For companies, insert the company legal name.
For superannuation fund, family trust or minor, if the trustee is an individual,
please insert the trustee given name(s) and surname.
If the trustee is a company, please insert the company legal name.
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For account designation, ensure you insert the name of the Superannuation
fund, trust name as per trust deed, or minor’s name as per birth certificate.
2. REGISTERED ADDRESS: Insert the full address including the postcode exactly as
printed on seller’s holding statement.
3. CONTACT PHONE NUMBER OF SELLER: Insert the seller’s contact phone
number(s) including area code.
4. PID (PARTICIPANT IDENTIFICATION NUMBER): Insert Participant Identification
Number (if applicable). This is the seller’s sponsoring broker where security is
held. (E.g. Australian Investment Exchange PID 6381)
5. TRADING A/C: Insert the Trading Account number where securities are currently
held (where applicable).
6. SRN (SECURITYHOLDER REFERENCE NUMBER) or HIN (HOLDER
IDENTIFICATION NUMBER): This number can be found on the Issuer Holding
statement or a CHESS holding statement. For issuer sponsored and broker
sponsored holdings (uncertificated), the seller’s SRN or HIN must be quoted as
confirmation of the seller’s authority for the transfer to be processed. Failure to
include the seller’s SRN or HIN may result in the transfer being returned to you
for clarification.
SECTION B - BUYER(S)/TRANSFEREE(S) DETAILS
7. ACCOUNT REGISTRATION NAME OF BUYER: Full names of all buyers (a
maximum of three joint holders). Securities can only be registered in the name of
a living person or an incorporated company.
For companies, insert the company legal name. Securities may not registered in
the name(s) of a firm or business name, an estate or deceased person, a fund or
a trust, although these may be inserted as an account designation underneath the
registered names. Some companies may also have restrictions on minors being
registered (e.g. BHP and CBA).
If the trust or superannuation fund trustee is an individual, please insert the
trustee given names and surname.
If the trustee is a company, please insert the company legal name.
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For account designation, ensure you insert name of the Superannuation fund,
trust name as per trust deed, or minor’s name as per birth certificate.
8. REGISTERED ADDRESS: Insert the full address including the postcode exactly
as printed on the buyer’s holding statement, trading account or within postal
guidelines of new holdings.
9. CONTACT PHONE NUMBER OF BUYER: Insert the buyer’s contact phone
number(s) including area code.
10. PID (PARTICIPANT IDENTIFICATION NUMBER): Insert Participant Identification
Number (if applicable). This is the buyer’s sponsoring broker where security will
be held. (E.g. Australian Investment Exchange PID 6381)
11. TRADING A/C: Insert the Trading Account number where the securities are to be
held (where applicable).
12. SRN (SECURITYHOLDER REFERENCE NUMBER) or HIN (HOLDER
IDENTIFICATION NUMBER): The buyer’s SRN or HIN may be inserted, if known,
so that any previous holdings may be amalgamated.
SECTION C – SECURITY DETAILS
13. SECURITY NAME: The full name of the company or trust in which the securities
are held (e.g. Commonwealth Bank of Australia, Woolworths Limited, Reef Casino
Trust, etc.) and the ASX Code.
14. ASX CODE: The unique trading code of the security used by the Australian Stock
Exchange (ASX) (e.g. the ASX code for the Commonwealth Bank is CBA, for
Woolworths Limited is WOW, for Reef Casino Trust is RCT, etc.).
15. DESCRIPTION OF SECURITIES: e.g. Fully Paid Ordinary 50 cent Shares,
9% Unsecured Convertible Notes, etc. This can be found on the certificate or
statement.
16. UNITS: Number of securities being transferred (both in numbers and words).
17. CONSIDERATION: The full amount paid in settlement of the transfer of securities.
You may set your own consideration.
18. DATE OF TRANSFER: Insert date of purchase. Please note this is not the date of
the purchase agreement but the date of completion of the transfer. This should
be on or before the date in points 20 and 22.
SECTION D – SIGNATURES
19. SELLERS SIGNATURE:
Joint holders – all holders must sign.
Under Power of Attorney – if not already noted, a certified copy of the Power of
Attorney must be sent with the transfer form to the share registry
Deceased Estate – all executors should sign and, if not already noted, a certified
copy of Probate or Letters of Administration must be sent with the transfer form
to the share registry.
Company – signatures of two directors (or a director and the secretary) or if there
is a sole director, signature of that director.
20. DATE SIGNED (Seller): Insert the date signed by the seller. This should be the
same as or after the date of transfer.
21. BUYER SIGNATURE: Same requirements as point 19.
22. DATE SIGNED (Buyer): Insert the date signed by the buyer. This should be the
same as or after the date of transfer.
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Guidelines for completing this form
