HEADING

Buy Shares

First name

Last name

Company Name (optional)

Address

Phone

Please enter the number of shares you wish to purchase. Each share is worth £1. There is a minimum price of £250.

Section B

This section should be completed if you would like to nominate a person to receive your shares on your death.

You can nominate a person to whom you wish your shares to be transferred on your death. Your wishes will be respected as far as the law and our Rules permit. Alternatively, you can nominate Golden Lion Community Pub and Hub Limited as the recipient on your death. If left blank the shares will be treated as part of your estate.

Nominee’s Full Name

Nominee’s Address

I have read and understood the share offer document.

I understand that purchasing shares makes me a member of Golden Lion Community Pub and Hub Limited.

I understand that this is a long term investment and that I could lose part or the whole value of my investment if the business does not succeed. Shares are only withdrawable at the discretion of the Management Committee if the Society can afford it.

I agree that Golden Lion Community Pub and Hub Limited may communicate with me by email, post or phone.

I hereby confirm that all details on this form are correct to the best of my knowledge.

I confirm that Golden Lion Community Pub and Hub Limited may hold the personal data I have submitted in this application in accordance with the General Data Protection Regulation.