APPENDIX I

MALTA STOCK EXCHANGE

Formal Application for Admission of Securities to the Official List & Any Other Recognized List

To: The General Manager

Malta Stock Exchange

Garrison Chapel

Castille Place

Valletta, Malta

__________________20____

We,____________________________ (Name of Issuer)⁽¹⁾ hereby apply for the under mentioned securities to be admitted to the Official List or __________________[other recognized list] of the Malta Stock Exchange subject to the Financial Markets Act (Cap. 345) and admission rules, continuing listing obligations and disclosure requirements contained in the Listing Rules and the Bye-laws of the Exchange.

1. ISSUER DETAILS

Name of Issuer : ______________________________________________________________

Address of Registered Office : ________________________________________________________

________________________________________________________

Telephone Nº : ________________________________ Fax Nº : _______________________

e-mail address :

Date of Registration : _______________________________________________________________

Registration Nº : ___________________________________________________________________

Income Tax Registration Nº : _________________________________________________________

2. SHARE CAPITAL
Authorized Amount	in	Issued (and paid up) include present issue (if applicable)

3. Amounts and descriptions of securities for which application is being made (include distinctive numbers if any):

_________________________________________________________________

4. The securities for which application is now made:

(a) are/are not identical ⁽²⁾in all respects :

_______________________________________________________________

(b) are/are not identical ⁽²⁾in all respects with an existing class of security :

______________________________________________________________

_______________________________________________________________

(d) have been in the previous six months, or will be subject of an application for listing on the following stock exchange(s):

_______________________________________________________________

5. So far as is known, or can be ascertained after reasonable enquiry by the directors of the company, the under mentioned is/are (a) substantial shareholder(s) ⁽³⁾of the company or of its holding company [substantial shareholders as defined in Listing Rule 3.22.1]:

Name

Address

Extent of Holding

and in which company

6. DIRECTORS’ DECLARATION

(i) We declare that :

(a) The Issuer has obtained authorization/or is in the process of obtaining authorization to listing by the Listing Authority or is subject to possible recognition by the Listing Authority, of an admissibility granted by a competent authority in a foreign jurisdiction as may be laid out by Regulations issued in terms of the FMA for those securities in respect of which this application to admission to listing on the Malta Stock Exchange is being made/application has been made;

(b) all the admission requirements contained in the Bye-laws of the Malta Stock Exchange, insofar as applicable and required to be met or fulfilled prior to application, have been met or fulfilled in relation to the Issuer and the securities for the admission of which application is now made; and

(c) there are no other facts bearing on the Issuer’s application for admission of its security to the Official List or any other recognized list which, in our opinion, should be disclosed to the Malta Stock Exchange.

(ii) We undertake to comply with the listing rules, admission rules, continuing listing obligations and disclosure standards presently in force and as they may from time to time be amended by the Listing Authority and /or the Council of the Malta Stock Exchange.

______________________ ______________________

Director Director

______________________ ______________________

Director Director

(To be signed by all the directors of the Company)

7. DETAILS OF SPONSOR

Sponsor’s Name : _________________________________________________

Address : _________________________________________________

_________________________________________________

Signed : _________________________________________________

(Sponsor)

NOTES

(1) Insert name of issuer securities.

(2) “Identical” in this context means :

(a) the securities are of the same nominal value with the same amount called up or paid up;

(b) they are entitled to dividend/interest at the same rate and for the same period, so that at the next ensuing distribution the dividend/interest payable per unit will amount to exactly the same sum (gross and net);

(c) they carry the same rights as to unrestricted transfer, attendance and voting at meetings and are pari passu in all other respects.