VIS
Vertex International Securities
Licensed Dealing Member - Dar es Salaam Stock Exchange
Zambian High Commission, Annex Building, Sokoine/Ohio Street,
P.O.Box 13412, Dar es Salaam, Tanzania Tel 2116382/2110387
SALE ORDER FORM
Register Ref.No
Subject to Rules and practices of the DSE
APPLICANT’S DETAILS:
Name in Full
Postal Address
Telephone number(s)
Identification /Passport No.
Nationality
Banker:
Branch:
A/C number:
Bank account details
SECURITIES TO BE SOLD:
Security
Quantity
(Number)
Quantity in words
Minimum
price/share
Limit order date
DECLARATION:
By signing the Sale authorization form I/We undertake that I/We authorize
Vertex International Securities Ltd to sell the above securities on my/our behalf.
Signature (1)_________________________Signature (2)____________________Date________
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FOR OFFICE USE ONLY: (To be completed by Interviewing Officer)
Received CDS Receipt/Share certificate number____________________
Identification verified_________________________________________
Name of Staff_________________________Signature_______________Date________