Apply for Olympic Accessories Shares

Interested persons are entitled to a prospectus, if they so desire.
Copies of prospectus may be obtained from the issuer and issue manager
OLYMPIC ACCESSORIES LIMITED

APPLICATION FORM
Warning: Please read the instructions on the back of this form. Incorrectly filled applications may be rejected.
The Managing Director

Olympic Accessories Limited
House # 54, Road # 08, Block # D,
Niketon, Gulshan-01, Dhaka-1212
Bankers Sl. No.
Dear Sir,
I/we apply for and request you to allot me /us the.....500.....numbers of Shares and I/we agree to accept the same or any
smaller number that may be allotted to me/us upon terms of the Companys approved Prospectus and subject to the
Memorandum and Articles of Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register
of Members of the Company and deposit the said shares to my BO (Beneficiary Owner) Account and/or a Crossed (Account
Payee only) Cheque in respect of any application money refundable by post/courier at my/our risk to the first applicants address
stated below:
1. No. of Ordinary Shares......500.....of Tk. 10/= per share.
2. Amount of Tk. (in figure).......5000/=......Taka (in words).Five Thousand.only deposited vide
Cash/Cheque/Draft/Pay Order No...........Cash...dated.......drawn on.......................................................Branch.
3.Depository (B/O) Account Number
(If you do not mention your valid BO (Beneficiary Owners) account, your application will be treated as invalid)
4. I/We agree to fully abide by the instruction given herein.

5. Particulars of Applicant(s):
Sole/First Applicant: Mr/Mrs/Ms. MOHAMMAD RASHEDUL HASSAN
Fathers/Husbands Name: LATE MOHAMMAD MOKTER HOSSAIN
Mothers Name: MRS. BILKIS HOSSAIN
Postal address: 113/1, Sher-e-Bangla Road (Beside Sata Masjid), Dhaka-1209
Occupation: Private Service
Nationality:
Bangladeshi
Branch:
Satmasjid Road
For Refund Warrant: Applicants Bank A/C No.: 171.101.13123

Name of the Bank: Dutch-Bangla Bank Limited
Second Applicant: Mr/Mrs/Ms.
Fathers/Husbands Name:
Mothers Name:
Postal address:
Occupation:
Nationality:
6. I/we hereby declare that I/we have read the Prospectus of Olympic Accessories Limited and have willingly
subscribed for....500... No. of Shares of Tk. 10/= per share.
7. Specimen Signature(s):
i) Name (in Block Letters):
MOHAMMAD RASHEDUL HASSAN
ii) Name (in Block Letters):
Signature:
Signature:
BANKERS ACKNOWLEDGEMENT
Certified that this Bank has received Tk......5000/=............ (In words)...........Five Thousand............only from
Mr./Mrs/Ms..MOHAMMAD RASHEDUL HASSAN & being the Application Money for..........500.........Nos. of Ordinary
Shares of Olympic Accessories Limited
Bankers SL. No.
Seal & Date
Authorized Signature
(Name & Designation)
Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and issue manager

APPLICATION FORM

Bankers Sl. No.
Dear Sir,
stated below:

Sole/First Applicant: Mr/Mrs/Ms. MOHAMMAD RASHEDUL HASSAN
Nationality:
Bangladeshi
Branch:
Satmasjid Road

Second Applicant: Mr/Mrs/Ms. RAJ PRATIM BHOWMIK

Fathers/Husbands Name: GOPAL BHOWMIK
Mothers Name: PADMA BHOWMIK
Postal address: 264/1, Sher-e-Bangla Road, Jafrabad, Mohammadpur, Dhaka-1207
Nationality:
Bangladeshi
MOHAMMAD RASHEDUL HASSAN
ii) Name (in Block Letters): RAJ PRATIM BHOWMIK
Signature:
Signature:
Mr./Mrs/Ms..MOHAMMAD RASHEDUL HASSAN & RAJ PRATIM BHOWMIK being the Application Money
for..........500.........Nos. of Ordinary Shares of Olympic Accessories Limited
Bankers SL. No.
Seal & Date

APPLICATION FORM

Bankers Sl. No.
Dear Sir,
stated below:

Sole/First Applicant: Mr/Mrs/Ms. MOHAMMAD IMAM HASSAN
Nationality:
Bangladeshi
Branch:
Satmasjid Road

Mothers Name:
Postal address:
Occupation:
Nationality:
MOHAMMAD IMAM HASSAN
Signature:
Signature:
Mr./Mrs/Ms..MOHAMMAD IMAM HASSAN & being the Application Money for..........500.........Nos. of Ordinary Shares of

Bankers SL. No.
Seal & Date

APPLICATION FORM

Bankers Sl. No.
Dear Sir,
stated below:

Sole/First Applicant: Mr/Mrs/Ms. MOHAMMAD IMAM HASSAN
Nationality:
Bangladeshi
Branch:
Satmasjid Road

Second Applicant: Mr/Mrs/Ms. NADIRA AKTER
Fathers/Husbands Name: LATE MOKTER HOSSAIN
Mothers Name: BILKIS HOSSAIN
Occupation: Housewife
Nationality:
Bangladeshi
MOHAMMAD IMAM HASSAN
ii) Name (in Block Letters): NADIRA AKTER
Signature:
Signature:
Mr./Mrs/Ms..MOHAMMAD IMAM HASSAN & NADIRA AKTER being the Application Money for..........500.........Nos. of
Ordinary Shares of Olympic Accessories Limited
Bankers SL. No.
Seal & Date

APPLICATION FORM

Bankers Sl. No.
Dear Sir,
stated below:

Sole/First Applicant: Mr/Mrs/Ms. MONIRA AKTER
Nationality:
Bangladeshi
Branch:
Satmasjid Road
For Refund Warrant: Applicants Bank A/C No.: 150380061093

Name of the Bank: BRAC Bank Limited
Mothers Name:
Postal address:
Occupation:
Nationality:
MONIRA AKTER
Signature:
Signature:
Mr./Mrs/Ms..MONIRA AKTER & being the Application Money for..........500.........Nos. of Ordinary Shares of Olympic
Accessories Limited
Bankers SL. No.
Seal & Date

APPLICATION FORM

Bankers Sl. No.
Dear Sir,
stated below:

Sole/First Applicant: Mr/Mrs/Ms. MONIRA AKTER
Nationality:
Bangladeshi
Branch:
Satmasjid Road
For Refund Warrant: Applicants Bank A/C No.: 150380061093

Name of the Bank: BRAC Bank Limited
Second Applicant: Mr/Mrs/Ms. BILKIS HOSSAIN
Mothers Name: LATE AMENA BEGUM
Nationality:
Bangladeshi
MONIRA AKTER
Signature:
ii) Name (in Block Letters): BILKIS HOSSAIN
Signature:
Mr./Mrs/Ms..MONIRA AKTER & BILKIS HOSSAIN being the Application Money for..........500.........Nos. of Ordinary Shares
of Olympic Accessories Limited
Bankers SL. No.
Seal & Date

APPLICATION FORM

Bankers Sl. No.
Dear Sir,
stated below:

Sole/First Applicant: Mr/Mrs/Ms. NADIRA AKTER
Fathers/Husbands Name: LATE MOKTER HOSSAIN
Nationality:
Bangladeshi
Branch:
Satmasjid Road

Mothers Name:
Postal address:
Occupation:
Nationality:
NADIRA AKTER
Signature:
Signature:
Mr./Mrs/Ms..NADIRA AKTER & being the Application Money for..........500.........Nos. of Ordinary Shares of Olympic
Accessories Limited
Bankers SL. No.
Seal & Date

APPLICATION FORM

Bankers Sl. No.
Dear Sir,
stated below:

Sole/First Applicant: Mr/Mrs/Ms. MRS. BILKIS HOSSAIN
Mothers Name: LATE AMENA BEGUM
Nationality:
Bangladeshi
Branch:
Satmasjid Road

Mothers Name:
Postal address:
Occupation:
Nationality:
MRS. BILKIS HOSSAIN
Signature:
Signature:
Mr./Mrs/Ms..MRS. BILKIS HOSSAIN & being the Application Money for..........500.........Nos. of Ordinary Shares of

Bankers SL. No.
Seal & Date

Apply for Olympic Accessories Shares

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Interested persons are entitled to a prospectus, if they so desire.

OLYMPIC ACCESSORIES LIMITED

The Managing Director

Bankers Sl. No.

3.Depository (B/O) Account Number

4. I/We agree to fully abide by the instruction given herein.

For Refund Warrant: Applicants Bank A/C No.: 171.101.13123

MOHAMMAD RASHEDUL HASSAN

ii) Name (in Block Letters):

Seal & Date

OLYMPIC ACCESSORIES LIMITED

The Managing Director

Bankers Sl. No.

3.Depository (B/O) Account Number

4. I/We agree to fully abide by the instruction given herein.

For Refund Warrant: Applicants Bank A/C No.: 171.101.13123

Second Applicant: Mr/Mrs/Ms. RAJ PRATIM BHOWMIK

MOHAMMAD RASHEDUL HASSAN

ii) Name (in Block Letters): RAJ PRATIM BHOWMIK

Seal & Date

OLYMPIC ACCESSORIES LIMITED

The Managing Director

Bankers Sl. No.

3.Depository (B/O) Account Number

4. I/We agree to fully abide by the instruction given herein.

For Refund Warrant: Applicants Bank A/C No.: 171.101.59113

MOHAMMAD IMAM HASSAN

ii) Name (in Block Letters):

Olympic Accessories Limited

Seal & Date

OLYMPIC ACCESSORIES LIMITED

The Managing Director

Bankers Sl. No.

3.Depository (B/O) Account Number

4. I/We agree to fully abide by the instruction given herein.

For Refund Warrant: Applicants Bank A/C No.: 171.101.59113

MOHAMMAD IMAM HASSAN

ii) Name (in Block Letters): NADIRA AKTER

Seal & Date

OLYMPIC ACCESSORIES LIMITED

The Managing Director

Bankers Sl. No.

3.Depository (B/O) Account Number

4. I/We agree to fully abide by the instruction given herein.

For Refund Warrant: Applicants Bank A/C No.: 150380061093

ii) Name (in Block Letters):

Seal & Date

OLYMPIC ACCESSORIES LIMITED

The Managing Director

Bankers Sl. No.

3.Depository (B/O) Account Number

4. I/We agree to fully abide by the instruction given herein.

For Refund Warrant: Applicants Bank A/C No.: 150380061093

ii) Name (in Block Letters): BILKIS HOSSAIN

Seal & Date

OLYMPIC ACCESSORIES LIMITED

The Managing Director

Bankers Sl. No.

3.Depository (B/O) Account Number

4. I/We agree to fully abide by the instruction given herein.

For Refund Warrant: Applicants Bank A/C No.: 171.101.58582

ii) Name (in Block Letters):