CM 28 Directors contract to Take shares of company as qualification shares

Form CM 28

REPUBLIC OF NAMIBIA

BUSINESS AND INTELLECTUAL PROPERTY AUTHORITY - BIPA

COMPANIES ACT 2004

(Section 219(1)(b)) (Regulation 45(2))

DIRECTOR'S CONTRACT TO TAKE SHARES OF COMPANY

AS QUALIFICATION SHARES

Name of company

I,

(full names of director)

hereby agree to take and pay for the following shares of the company, as qualification shares, in terms of article

of the company's articles of association.

Number of shares

Class of shares

Nominal par value

of share

Premium per share

Issue price of no par value share

Amount Paid

Total N$

Signed at

this

day

of

of the year

Signature _______________________

Director

Witness _________________________________________

Name in block capitals

Residential address

Email address

Signature ______________________

Witness

Copyright: Business and Intellectual Property Authority, Namibia

N$ 20,00 fee payable in terms of the Act and as set out in the regulations

Registration Number of Company