Deposit Form - Computershare

.
Print
Complete this form by filling out the following sections:
1 Name & Address of first named shareholder and names of
all other shareholders
2 Shareholder Reference Number
1>
Reset
Allcorrespondence
correspondence to:
All
to:
Computershare
PLC,
ComputershareInvestor
Investor Services
Services PLC,
PO Box XX, The
The Pavilions,
Pavilions,
Bridgwater Road, Bristol XXXX XXX
Bridgwater Road, Bristol BS99 6ZY
Telephone XXX XXX XXXX
UK
Telephone:
0800
4350
21
Facsimile
XXX
XXX
XXXX
Overseas
Telephone:
703 6364
TextPhone
users
please +44(0)870
call 0870 702
0005
TextPhone users please call
702Bristol
0005
DX:0870
78139
www.computershare.com
DX: 78139 Bristol
www.computershare.com
Shareholder Reference Number
2>
RIOU
*
*
*
*
THIS FORM MUST BE PRINTED DUPLEX
Deposit Form
Kindly Note: This form is issued only to the addressee(s) and is specific to the unique designated account printed hereon. This personalised
form is not transferable between different (i) account holders; or (ii) uniquely designated accounts. The Company and Computershare Investor
Services PLC accept no liability for any instruction that does not comply with these conditions.
A.
Number of Shares to be Deposited
Number of shares
you wish to deposit.
FOLD
........
HERE
B.
In
Figures
ALL
FOLD
........
should
be made
payable
to Computershare
Investor
Services
PLC PLC.
Fees -1Cheques
- Cheques
should
be made
payable
to Computershare
Investor
Services
A fee of
C.
In
Words
A L L
HERE
is chargeable for this transaction.
Signature(s) - to be signed by all the registered holders listed above.
1 I/We
transfer
above
shares
forconsideration
no consideration
to Computershare
Company
Nominees
to for
be me/us
held for
the Nominee
StandardService
Life Nominee
Share Account.
I/We
transfer
the the
above
shares
for no
to Computershare
Company
Nominees
Limited,Limited,
to be held
in me/us
the RioinTinto
Share Account.
2 I/We
declare
the terms
and conditions
and
the current
Standard
Life
Nominee
Share
Dealing
Facility
and Conditions
andtoagree
to bebybound
them
I/We
declare
thatthat
I/weI/we
havehave
readread
the terms
and conditions
and the
current
Rio Tinto
Nominee
Service
Share
Dealing
Facility
TermsTerms
and Conditions
and agree
be bound
them by
to the
extent
3 tothey
the extent
they apply to me/us.
that
apply tothat
me/us.
4 I/We
confirm
deposit
of these
shares
not represent
a change
in beneficial
ownership.
I/We
confirm
thatthat
the the
deposit
of these
shares
does does
not represent
a change
in beneficial
ownership.
You must send your share certificate(s) with this form
Date
Signature 1 (Please sign in the box below)
Signature 3 (Please sign in the box below)
Signature 2 (Please sign in the box below)
Signature 4 (Please sign in the box below)
D.
Transferee Details -
DD / MM / YY
to whom the shares are to be transferred
Name of CREST member
Computershare Company Nominees Limited
CREST Participant ID
C C X 1 5
Address of CREST member
The Pavilions, Bridgwater Road, Bristol
Post Code
B S 9 9 7 N H
Counter Location Stamp
SDRN Barcode or Reference
RIOU
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How to complete this form
Please use a black pen. Print in
CAPITAL letters inside the boxes
as shown in this example.
A B C
1 2 3
X
1 Complete this form if you currently hold your ordinary shf XXp in a certificated account and wish to transfer them into the Standard
thisAccount.
form if you currently hold your Ordinary shares in a certificated account and you wish to transfer them into the Rio Tinto Nominee
2Complete
Life Share
Service
Share
3 XXXXXXX Account.
A
Number of Shares to be Deposited
1 Enterenter
the amount
of shares
in words
andtofigures.
Please
the amount
of shares
you wish
deposit in words and figures.
2
3
B.
Fees
1If aIffee
a fee
is shown
as payable,
please aenclose
a cheque
for amount
the required
amounttomade
payable Investor
to Computershare
Services
is shown
as payable,
please enclose
cheque for
the required
made payable
Computershare
Services PLC.Investor
Please note,
we canPLC
onlyto
accept
2third-party
cover the
deposit
Pleasestockbroker
note this or
transaction
will notwhen
be processed
required
not enclosed.
cheques
fromcharge.
your registered
registered solicitor
they provideifa the
covering
letter fee
that is
demonstrates
your relationship with them.
C.
Signature(s)
You must sign the form as follows in the space provided:
Joint Holding:
The signatures of all joint holders, executors or administrators are required. If the holder is under 18, a parent
or legal guardian must sign and state their capacity.
Power of Attorney:
To sign under Power of Attorney, you must have already lodged an original or certified copy of the Power of
Attorney with the registrar. If you have not previously lodged this document for notation, please attach it to this
form when you return it.
Please note that Computershare Investor Services PLC requires a photocopy Power of Attorney to be certified
under the Powers of Attorney Act 1971. It must be certified in ink on every page by the donor, or by a solicitor
or stockbroker, to state that it is a true and complete copy of the original. Computershare Investor Services
PLC cannot accept a photocopy that has not been certified in ink on every page.
Companies:
D.
The form should be signed by two authorised signatories of the Company, whose representative capacities (e.g.
Director and Company Secretary) must be stated. Alternatively, Computershare Investor Services PLC will
accept just one authorised signature; however, the signatory’s capacity must be stated and the form must be
impressed with the Company Seal.
Transferee Details
1This
Thissection
section
must
completed
in full.
must
be be
completed
in full.
Please return this form to: Computershare
1 Computershare
Investor
Services
Box 82,Bristol
The Pavilions,
Investor
Services
PLC,PLC,
TheP.O.
Pavilions,
BS99 6ZZBridgwater Road, Bristol BS99 7NH
2
PLEASE
REMEMBER
TO RETURN
ALL
RELEVANT
SHARE CERTIFICATES
WITH
THIS FORM
KINDLY NOTE THAT IT IS
NECESSARY
TO RETURN
YOUR
SHARE
CERTIFICATE(S)
OR ACCOUNT
STATEMENT
FOR AMENDMENT
1
2
3
4
5
6
7
8
9
10
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Computershare Investor Services PLC, Registered in England & Wales, Company No. 3498808, Registered Office: The Pavilions, Bridgwater Road, Bristol BS13 8AE.
Computershare Investor Services PLC is Registered in England & Wales, No 3498808, Registered Office, The Pavilions, Bridgwater Road, Bristol BS13 8AE
Computershare Investor Services PLC is authorised and regulated by the Financial Conduct Authority.
Computershare Investor Services PLC is authorised and regulated by the Financial Services Authority
ADOBEDFv5