How to apply for Shares to Save The Bell

There are 3 ways you can apply for shares, the preferred method is by using the online form below, or you could download a copy by selecting the the download paper form button or by collecting a form from the Abberley Village Store. Completing a paper based form will require it being posted to the address provided.

TEST Only!!!!!

Share Application Form

This form permits you to apply for shares as an individual, on behalf of a company, or to gift to another named person or child, i.e. a Giftee, whose details you can input on Section B.

SECTION A - Details of the person completing this application

First name

Last name

Company

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Please advise if you orignally made a pledge

Yes

Unsure

If this is a joint application, 2nd and subsequent investors should be listed here with full name and address

SECTION B - Gifting shares (optional)

This section should only be completed if you would like to purchase shares for somebody as a gift. If you are not buying shares as a gift, move to section C

I wish to apply for shares in The Bell at Pensax Community Pub Limited as a gift for the following person (Giftee). Please confirm either Option 1 or 2 below

Option 1 : I confirm that the Giftee is over the age of 16 and acknowledges the shares bought on their behalf and will accept the terms of membership of the Society.

Option 2 : The giftee is under the age of 16, therefore the purchaser must complete section A above and be eligible for membership in their own right, as the shares will be in their own name and treated as their own property. On the day the Giftee becomes 16 the society will write to both the giver and the recipient, asking the giver to consent to withdrawal of the allocated share capital, and ask

Name of the Person being Gifted Shares

Giftees Age and Date of Birth (if under 16)

Giftees Full Address

Giftees Email Address

Giftees Contact Number

SECTION C - Nomination on death

This section should be completed if you would like to nominate a person to receive your shares on your death. Please note a nomination can only be made on shares to the value of £5000, all shares above this value must be treated as part of your estate on 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 The Bell at Pensax Community Pub Limited as the recipient on your death. If left blank the shares will be treated as part of your estate.

Select an option

Option 1: The shares will be treated as part of my estate.

Option 2: I wish to nominate The Bell at Pensax Community Pub Limited as recipient of my shares on my death.

Option 3: Person (‘Nominee’) you wish your shares to be transferred to:

Nominee's Full Name

Nominee's Full Address

Nominee's Email Address

Nominee's Contact Number

I understand that these instructions can only be revoked or amended in writing to the Secretary of the CBS at the Registered Office.

SECTION D - Selecting the value and paying for shares

In this section, you can confirm the total value of shares (based on £250 per share) you wish to apply for and also confirm payment details (please note payment can only be accepted in GBP and that non-UK residents will be subject to identity checks). For traceability, we prefer online payment via BACS but cheques are also accepted. Once your money is received it will be acknowledged and held on deposit by The Bell at Pensax Community Pub Limited. If the purchase of the pub does not proceed, it will be returned in full.

Other Amount (minimum and muliples of £250 per share):

How to make payment

There are two ways to provide payment (please note payment can only be accepted in GBP and that non-UK residents will be subject to identity checks). For traceability, we prefer online payment via BACS but cheques are also accepted. Once your money is received it will be acknowledged and held on deposit by The Bell at Pensax Community Pub Limited. If the purchase of the pub does not proceed, it will be returned in full.

Before sending payment, you now need to create a unique reference ID that must be used when completing your bank transfer or to be written on the back of the cheque. This will help us to identify your payment

● First character of first name (e.g. M for Mary)

● First 3 characters of surname (e.g. SMI for Smith)

● Last 4 numbers of your phone number (e.g. 1234)

● This example would generate the reference: MSMI1234

Enter you unique reference ID (IN BLOCK CAPITALS)

Confirm the name of the person making payment

Confirm the name of the bank

Please send payments using the details below. Our account details will only be shared on the application form, when making payment, ensure you have an exact match using our account name before making any transfer.

The Bell at Pensax Community Pub Limited BACS Details (Lloyds Bank)

Account name: The Bell at Pensax Community Pub Limited

Sort code: 30-99-50

Account number: 61027960

For International payments (in GBP ONLY)

IBAN: GB12LOYD30995061027960

BIC: LOYDGB21287

Cheques are payable to The Bell at Pensax Community Pub Limited and must be posted to The Treasurer, The Bell at Pensax Community Pub Ltd, Westcroft, Bank Lane, Abberley, Worcestershire, WR6 6BQ. Remember to write your unique ID on the back.

SECTION E - Confirmations

All must be ticked to allow us to process and manage your investment

I have read and understood the share offer document.

I understand that purchasing shares makes me a member of The Bell at Pensax Community Pub Ltd.

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 Board if the business can afford it.

I agree that The Bell at Pensax Community Pub Ltd may hold the personal data submitted in this application and understand that this information will be used for maintaining a register of Members and shares as required by the rules of the Society and for communicating the activities of The Bell at Pensax Community Pub Ltd. The sum invested will be confidential and all information will be treated in

I have sent the required payment using my unque code.

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

Confirmation of receipt of the application will be received immediately, confirmation that payment has been received will be within 5 working days by email as we reconcile payments with applications. Share Certificates will be forwarded either by email or by post after the sale has be completed.

By signing the application form you confirm that you will provide proof of identity and address if required.

We are not obliged to accept your application. We may also choose to issue less than the full number of shares you have applied for.

Data Protection Policy: The data provided by you on this form will be stored on a computerised database. Your data will only ever be used for The Bell at Pensax Community Pub Ltd’s purposes and will never be shared with a third party.

Thank you for submitting your application. You will receive confirmation of receipt via the email address provided

info@savethebellatpensax.co.uk

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