DIVIDEND VOUCHER

(Company name, registration number and registered office address)

This certifies the payment of interim/final dividend of £x per each ordinary Share in
respect the financial year end (date) payable to shareholders

(Shareholder’s name and address)

No of ordinary shares …(enter shares held)

Dividend payment….(enter total amount of dividend)
Tax credit ….(enter as 0%)

Signed by: (director/company secretary) (position)

Date…..