Botanic Wellness Limited
Pre-IPO application form
This investment is only suitable for Wholesale investors under s708 of the Corporations Act 2001.
This investment is only suitable for Wholesale investors under s708 of the Corporations Act 2001.
Applications must be made on by filling out the online Application Form below. OR by filling out the paper copy here. If you wish to fill out the paper application, please email the completed form to [email protected]
Please complete all parts of the Application Form. Insert the number of Shares you wish to apply for. The Applicant(s) agree(s) upon and is subject to the terms of the Offer to take any number of Shares equal to or less than the number of Shares indicated in a box that may be allotted to the Applicants declare(s) that all details of statements made are complete and accurate.Applicants agree to be bound upon acceptance by the Company of the Application.
Applications for Shares must be accompanied by the application money of twenty cents ($0.20) per share (in Australian currency). Cheques should be made payable to “XXX” and crossed “Not Negotiable”. Direct Deposits should be completed as per the instructions below. Direct Deposit details will be provided to you via email upon submitting the below application
Should an Application Form be completed incorrectly, the Company in its sole discretion may elect to accept or reject the Application and how to construe, amend or complete it but in no case whatsoever shall any Applicant be treated as having offered to acquire more shares than is indicated by the amount of the cheque or direct deposit for the application monies.
Applications must be in the name(s) of:
At least one first name and surname is required for each natural person.
The name of the Beneficiary or any other Non-Registrable name may be included by way of an Account Designation, if completed exactly as described in the example of the correct forms of Registrable Title:
Type of investor
Correct form of Registrable Title
Incorrect form of Registrable Title
Individual
John Alfred Brown, Use given names, not initials
(no more than 3 individuals can be registered)
JA Brown
Company
ABC Pty Ltd
Use Company title, not abbreviations
ABC P/L or ABC Co
Trusts
Sue Brown, Sue Brown Family A/C
Use Trustee(s) personal name(s)
Sue Brown Family Trust
Do not use the name of the Trust
Deceased Estates
Jane Brown, Est John Brown A/C
Use Executor(s) personal name(s)
Estate of late John Brown
Partnerships
John Brown + Michael Brown
Use partners’ personal names
John Brown and Son
Do not use the name of the partnership
Clubs/ Incorporated Bodies/ Business Name
Michael Brown, ABC Tennis Association A/C
Use Office Bearer(s) personal name(s)
ABC Tennis Association
Do not use the name of the club
Superannuation Funds
Jane Brown Pty Ltd Super Fund A/C
Use the name of the Trustee of Fund
Jane Brown Pty Ltd Superannuation Fund
Do not use the name of the Fund
This Application Form is important. If you are in doubt as to how to deal with it, please seek professional investment advice without delay. You should read the Information Memorandum dated November 2020 before completing this Application Form.