SHAREHOLDER
AGREEMENT

(A) Your email address

(1) The full name of the company

(2) Please state the company incorporation number

(3) Please state the date of incorporation

(4) What is the full Registered Office address of the company (including postcode)?

(5) What is the company's Accounting Reference Date (ARD)?

(6) What is the company's share capital? (If there are multiple share classes please advise us seperately).

(7) Please provide full names, addresses and current share allocation for all shareholders below - continue in additional information field at the end of the form if there are more than four shareholders:

(8) Should the Shareholders' Agreement specify a minimum or maximum number of directors? (Enter "none" if not relevant).

(9) Is there an appointed Chairman?Yes - please enter name belowNo - Please go to question 14

(10) Is a Chairman to be appointed? (we will do this if required).Yes - please enter name belowNo - Please go to question 16

(11) Should the Chairman have a casting vote?YesNo

(12) Enter the name, address and postcode of the company's Accountants / Auditors (Enter "none" if none appointed):

(13) Enter the name, address and postcode of the company's Bankers (Enter "none" if none appointed):

(14) Would a minority shareholder who is also an employee of the company be required to relinquish his or shares upon cessation of employment?Yes - please give details belowNo - please go to question 23

(15) Please specify the percentage shareholding below which shareholders would cease to be party to the agreement (Enter "none" if not relevant):

(16) If the agreement is not intended to run indefinitely, please specify your preferred expiry date below:

(17) Please specify below any other requirements not covered elsewhere in the questionnaire (or use this space to include the titles, names, addresses, postcodes and number of shares held for any additional shareholders not submitted in question 9).

Note: There may be an additional charge if extra time is required to redraft our standard document. We will advise you before commencing any work if applicable.