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                                       COMMERCIAL BANK OF ETHIOPIA

                                                                                   BRANCH

                               BRANCH APPLICATION FORM FOR PURCHASE OF

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                                        "EEPCO MILLENNIUM BOND"

 

 NAME OF THE APPLICANT:

 ADDRESS:

    PLACE OF PERMANENT RESIDENCE

   TEL:

               NATIONALITY

  OCCUPATION:

  PASSPORT/ETH. ORIGIN ID NO.:

  PLACE OF ISSUE:

       1. I WHOSE NAME AND ADDRESS STATED ABOVE HERE BY APPLY TO PURCHASE A

           BOND WITH FACE VALUE OF                                FOR              YEARS WITH  

           INTEREST RATE                                     UNDER THE TERMS AND CONDITIONS

           STIPULATED ON THE BOND CERTIFICATE AND THOSE THAT THE BANK MAY ISSUE

           IN THE FUTURE.

      2. I AGREE TO PRESENT THE ORIGINAL BOND CERTIFICATE AT THE TIME OF MATURITY.

      3. REGARDING CUSTODY OF THE BOND CERTIFICATE (INDICATE YOUR CHOICE BY

         MARKING IN ONE OF THE BOXES BELOW)

*              INSTRUCT THE BANK TO HOLD THE BOND ON BEHALF OF ME

*              INSTRUCT THE BANK TO SEND ME THROUGH MY ADDRESS INDICATED ABOVE

*              I WILL TAKE IT WITH ME

    4. I FURTHER AGREE AND INSTRUCT THE BANK TO PAY ME INTEREST ON THE BOND

        IN THE FOLLOWING MANNER (INDICATE YOUR CHOICE BY MARKING IN ONE OF

        THE BOXES BELOW)

*        CREDIT MY A/C NO

*        PAY ME IN CASH AT THE BANK'S COUNTER

*        SEND ME THROUGH TRANSFER (THE TRANSFER CHARGES WILL BE COVERED BY THE BOND HOLDER)

*        PAY TO MY POWER OF ATTORNEY (AGENT)

 

(NAME AND ADDRESS OF THE POWER OF ATTORNEY HOLDER)

 

  NAME AND SIGNATURE OF THE MAKER  

NAME AND SIGNATURE OF THE BOND HOLDER

CERTIFICATE NO.

REMARKS