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Interested persons are entitled to a prospectus, if they so desire. Copies of prospectus may be obtained from the issuer and the issue manager
NATIONAL FEED MILL LIMITED
APPLICATION FORM
APPLICATION FOR SHARES BY OTHER THAN NON-RESIDENT BANGLADESHI(S)
(To be sent directly to the Companys Corporate Office)
Warning: Please read the instructions on the back of this form. Incorrectly filled Applications may be rejected.
The Managing Director
National Feed Mill Limited
House # 20/B, Road # 14
Sector # 04, Uttara, Dhaka-1230.
Bankers Sl. No.

Dear Sir,
I/we apply for and request you to allot me/us the
50

0
. numbers of Shares and I/we agree to accept the same or any smaller number that
may be allotted to me/us upon terms of the Company's Prospectus approved by the Securities and Exchange Commission subject to the
Memorandum and Articles of Association of the Company. Further, I/we authorize you to place my/our name(s) on the Register of Member(s) of
the Company and deposit the said ordinary shares in my Beneficiary Owner ("BO") account; I/we further authorize you to send a crossed
(Account Payee only) cheque in respect of any Application money refundable to me/us by post/courier at my/our risk to the first applicant's
address stated below:
1. No. of Ordinary Shares ............
5
..
0
..
0
............of Tk. ...
1
..
0
..
/
.
-
... each per share.
2. Amount of Tk. (in figures) ......
5
..
0
..
0
..
0
..
/
.
-
............Taka (in words) ...
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.........................................................................................
deposited vide Cash/Cheque/Draft/Pay Order No ................................................. dated............................................................................... on
....................................................................................................... Bank...................... .......................................................................... Branch.

3. Beneficiary Owner (BO) A/C No.
(If you do not mention your valid BO A/C No. your application will be treated as invalid)
4. I/we agree to fully abide by the instructions given herein.
5. Particulars of Applicant(s)
(a) Sole/First Applicant:

Sole/First Applicant Name: MD. MOIN UDDIN HOWLADER
Fathers/Husbands Name: MD. JAMAL UDDIN HOWLADER
Mothers Name: FERDOWSHI BEGUM
Mailing Address: 77/F/2, EAST RAMPURA, DHAKA 1219
Occupation: STUDENT Nationality: BANGLADESHI Phone (if any):
For Refunds: Please write the correct and full name of bank and branch (Application will not be treated as valid if any one uses a non-
scheduled bank. Applicants are requested not to use the name of any non-scheduled bank).
For refund purpose: I/we want refund through

Bank Account *

Hand Delivery / Courier ( put tick mark in which refund will be made)
For refund warrant: Applicants Bank A/C No: SB- 128358
Name of the Bank: PUBALI BANK LTD. Branch: RAMPURA BR. DHAKA
The applicant shall provide the same Bank Account number in the application form as it is in the BO account of the applicant.
(b) Second Applicant:

Second Applicant Name: MD. RASHED BEPARI
Fathers/Husbands Name: LATE MD. DALIL UDDIN BEPARI
Mothers Name: AMIRUNNECHA
Mailing Address: 77/F/2, EAST RAMPURA, DHAKA 1219
Occupation: BUSINESS Nationality: BANGLADESHI
6. I/we hereby declare that I/we have read the Prospectus of .....
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................................................................... and
have willingly subscribed for
50
..
0
...... No. of Ordinary Shares of Tk. ..
1
..
0
..
/
.
-
.. each per share.
7. Specimen Signature(s):
NAME IN BLOCK LETTERS SIGNATURE
1. Sole/First Applicant:
MD. MOIN UDDIN HOWLADER

2. Second Applicant:
MD. RASHED BEPARI


* In case of deposit into the applicants bank account, the applicant will bear the applicable service charge, if any, of the applicants banker, and the issuer shall simultaneously issue a letter of
intimation to the applicant containing, among others, the date and amount remitted with details of the bank through and to which bank such remittance has been effected.

BANKS ACKNOWLEDGEMENT
Certified that this Bank has received Tk. (in figure) ......
5
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0
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......... (in word: .....
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............................................................) only
from Mr./Mrs./Ms. .MD. MOIN UDDIN HOWLADER & MD. RASHED BEPARI.. being the application money
for ............
5
..
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..
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.............. nos. of ordinary shares of ..
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Bankers Sl. No Seal &Date Authorized Signature

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