Admedus Limited
ABN 35 088 221 078
For all enquiries:
Phone:
(within Australia) 1300 850 505 (outside Australia) 61 3 9415 4000
Web:
www.investorcentre.com/contact
OOOOO1000 AHZ
MR SAM SAMPLE
123 SAMPLE STREET
SAMPLETOWN VlC 3000
Make your payment:
See overleaf for details of the Offer and how to make your payment
Non-Renounceable Rights lssue - Entitlement and Acceptance Form
Your payment must be received by 5:00pm (AWST) Tuesday, 14 April 2015
This is an important document that requires your immediate attention. lt can only be used in relation to the shareholding represented by the details printed overleaf. lf you are in doubt about how to deal with this form, please contact your financial or other professional adviser.
Step 1: Registration Name & Offer DetailsDetails of the shareholding and entitlements for this Offer are shown overleaf.
Please check the details provided and update your address viawww.investorcentre.com if any of the details are incorrect.
lf you have a CHESS sponsored holding, please contact your
Controlling Participant to notify a change of address.
Step 2: Entitlement Taken Up
You can apply to accept either part or all of your entitlement. Enter overleaf, the number of New Shares you wish to accept from your entitlement.
Step 3: Shortfall Shares Applied For
Enter overleaf, the number of Shortfall Shares you wish to apply for
(if any). No Eligible Shareholder is assured of receiving any Shortfall Shares applied for in excess of their entitlement and any amount by which applications from Eligible Shareholders exceed their entitlements may be scaled back at the discretion of the Directors.
Step 4: Make Your Payment
You can apply to accept either all or part of your Entitlement. Enter the number of New Shares you wish to apply for and the amount of payment for those New Shares.
By making your payment you confirm that you agree to all of the terms and conditions as detailed in the Offer Document dated
20 March 2015.
Choose one of the payment methods shown below.
BPA®: See overleaf. Do not return the payment slip with BPAY
payment.
By Mail: Complete the reverse side of the payment slip and detach and return with your payment. Make your cheque, bank draft or money order payable in Australian dollars to "Admedus Limited" and cross "Not Negotiable". The cheque must be drawn from an Australian bank. Cash is not accepted.
Payment will be processed on the day of receipt and as such, sufficient cleared funds must be held in your account as cheques received may not be re-presented and may result in your
Application being rejected. Paperclip (do not staple) your cheque(s)
to the payment slip. Receipts will not be forwarded. Funds cannot be debited directly from your account.
Entering your contact details is not compulsory, but will assist us if we need to contact you.
Turn over for details of the Offer -+
Admedus Limited Non-Renounceable Rights lssue
Payment must be received by 5:00pm (AWST) Tuesday, 14 April 2015
® Registered to BPAYPty Limited ABN 69 079 137 518
916CR_0_Sample_CA/000001/000001/i
Entitlement and Acceptance Form with Additional Shares
2
X 9999999991
I N D
STEP 1
Registration Name & Offer DetailsFor your security keep your SRN/ HIN confidential.
Registration Name:
MR SAM SAMPLE
123 SAMPLE STREET
SAMPLETOWN VIC 3000
Entitlement No: 12345678
Offer Details:
Existing shares entitled to participate as at
26 March 2015:
Entitlement to New Shares on a 1 for 7 basis:
4,000
1
Amount payable on full acceptance
at $0.07 per New Share: $0.01
STEP 2 Make Your Payment
Biller Code: 999999
Ref No: 1234 5678 9123 4567 89
Contact your financial institution to make your payment from your cheque or savings account.
Pay by Mail:
Make your cheque, bank draft or money order payable to "Admedus Limited" and cross "Not Negotiable".
Return your cheque with the below payment slip to:
Computershare lnvestor Services Pty Limited
GPO BOX 505 Melbourne Victoria 3001 Australia
Lodgement of Acceptance
If you are applying for New Shares and your payment is being made by BPAY, you do not need to return the payment slip below. Your payment must be received by no later than 4:00pm (AWST) Tuesday, 14 April 2015. Applicants should be aware that their own financial institution may implement earlier cut off times with regards to electronic payment, and should therefore take this into consideration when making payment. Neither Computershare Investor Services Pty Limited (CIS) nor Admedus Limited accepts any responsibility for loss incurred through incorrectly completed BPAYpayments. It is the responsibility of the applicant to ensure that funds submitted through BPAYare received by this time.
If you are paying by cheque, bank draft or money order the payment slip below must be received by CIS by no later than 5:00pm (AWST) Tuesday, 14 April 2015.
You should allow sufficient time for this to occur. A reply paid envelope is enclosed for shareholders in Australia. Other Eligible Shareholders will need to affix the appropriate postage. Return the payment slip below with cheque attached. Neither CIS nor Admedus Limited accepts any responsibility if you lodge the payment slip below at any other address or by any other means.
Privacy Notice
The personal information you provide on this form is collected by Computershare Investor Services Pty Limited (CIS), as registrar for the securities issuers (the issuer), for the purpose of maintaining registers of securityholders, facilitating distribution payments and other corporate actions and communications. In addition, the issuer may authorise us on their behalf to send you marketing material or include such material in a corporate communication. You may elect not to receive marketing material by contacting CIS using the details provided above or emailing privacy@computershare.com.au. We may be required to collect your personal information under the Corporations Act 2001 (Cth) and ASX Settlement Operating Rules. We may disclose your personal information to our related bodies corporate and to other individuals or companies who assist us in supplying our services or who perform functions on our behalf, to the issuer for whom we maintain securities registers or to third parties upon direction by the issuer where related to the issuer's administration of your securityholding, or as otherwise required or authorised by law. Some of these recipients may be located outside Australia, including (but not limited to) the following countries: Belgium, Denmark, Germany, Luxembourg, the Netherlands, the United Kingdom, Hong Kong and Singapore. For further details, including how to access and correct your personal information, and information on our privacy complaints handling procedure, please contact our Privacy Officer at privacy@computershare.com.au or see our Privacy Policy at http://www.computershare.com/au.
Detach here
Admedus Limited Acceptance Payment Details
Entitlement taken up:
Number of Shortfall Shares applied for:
Amount enclosed at $0.07 per
New Share: A$
Entitlement No: 12345678
.
MR SAM SAMPLE
Payment must be received by 5:00pm (AWST) Tuesday, 14 April 2015
Contact Details
123 SAMPLE STREET
SAMPLETOWN VIC 3000
Contact
Name
Cheque Details
Drawer
Daytime
Telephone
Cheque Number BSB Number Account Number Amount of Cheque
123456789123456789+0000000001-3051+14
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