客戶股票提取/轉帳指示表格

SECURITIES WITHDRAWAL/TRANSFER INSTRUCTION FORM

請 注意 ： 客 戶需 於辦工 時間 (星 期一至 星期 五 ,公 眾假期 除外 )下 午 3 時 或之 前將 本表格 傳真 至本公 司 結算 部 (852) 2522 3878 辦 理股票 提
取 /轉帳指 示， 否則 該提取 /轉賬指 示將 安排於 下一 個工作 天處理 。
Note ： Clients are required to fax this settlement instruction form to the Settlement Department of our Company fax no.(852) 2522 3878 on or before
3 pm on the each business day (Monday to Friday except public holidays) , otherwise such withdrawal/transfer instructions will be handled by
us in the following working day.

客戶名稱 Client Name: 日期 Date:

帳戶號碼 Account No.: 聯絡電話 Contact No.:

□ (請於適當處畫上 “” 號) (Please “”tick where appropriate)

本人/吾等特此通知 貴公司 I/We hereby instruct your Company to:

□ 股票提取 - 將下列股票由以上帳戶提取及交付予本人/吾等*
Securities Withdrawal - release the following securities from the above account and deliver the same to me/us*

□ 股票轉帳 - 將下列股票由以上帳戶轉賬至本人/吾等帳戶號碼:
Securities Transfer - transfer the following securities from the above account to my/our account No.:

本人/吾等承諾就本提取/轉帳指示所可能令 貴公司蒙受或承擔的任何費用或開支作出彌償或使之獲得彌償。
I/We also undertake to indemnify and keep your Company indemnified in respect of any costs and expenses whatsoever which may be suffered or incurred by
you in connection with this withdrawal/transfer instruction.

* 客戶請於本公司通知可以領取股票後一星期內到達本公司領取。如過期仍未領取，客戶必須重新辦理提取股票實貨手續，所扣除費用將不發還。
Please note that client should pick up the requested securities at our office within one week after our Company informs you. Client must give another securities withdrawal
instruction to us after that period, and the deducted fees are non-refundable.

股票代號 Stock Code 股票名稱 Stock Name 股票數目 Quantity 提取費用(如適用) Withdrawal Fee (if any)

總費用 Total: $ (最低收費 Min $30)

由經紀或客戶主任接收提款指示及簽署, 需填寫以下記錄:
s.v. Instructions received by AE and CS staff, please complete the following records:

經紀或客戶主任名稱 Name of AE/CS:

接收日期 Received Date: 時間 Time:
客戶/經紀簽署 Client /AE Signature 電話內線 Telephone Ext.:
(客戶簽名式樣必須與本公司記錄相同) (Please use the same signature filed with our Company)
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股票提取專用 For securities withdrawal use only

本人/吾等確認收妥貴公司以下股票 I/We hereby confirm receiving the following securities from your Company
股票代號 Stock Code 股票名稱 Stock Name 股票證書號碼 Certificate Number 股票數目 Quantity

客戶簽署 Client Signature 日期 Date

(客戶簽名式樣必須與本公司記錄相同) (Please use the same signature filed with our Company
內部專用 For Official Use Only
Central Clearing Back-office
Handled by :
Checked by :
Approved by :

SEC_WT_201806