PURCHASE/DEPOSIT/ISSUANCE REQUEST

Transcription

1 PURCHASE/DEPOSIT/ISSUANCE REQUEST TO: JPMORGAN CHASE BANK, TAIPEI BRANCH Fax No.: Back-up Fax No.: RE: FROM: (DESCRIBE RELEVANT ADR ISSUE) (the "Issue") JPMORGAN CHASE BANK, DELAWARE OPERATIONS We forward the following received by us. Sequential No. 12 JPMorgan Chase Bank Delaware Authorized Signature

2 ADR ISSUANCE REQUEST FOR PURCHASE OF SHARES / DEPOSIT / ISSUANCE OF DEPOSITARY RECEIPTS OR DEPOSIT OF SHARES / ISSUANCE OF DEPOSITARY RECEIPTS ("REQUEST") TO: FROM: JPMORGAN CHASE BANK, DELAWARE OPERATIONS ("Requestor") Acting on behalf of: DATE: I. THE REQUEST 1. Mandatory Information a. Name of issuer b. Depositary JPMorgan Chase Bank, N.A. c. Requestor contact Requestor name Contact person Fax Telephone

3 d. Requestor's status (only required for deposit request) (1) Insider (as defined below) 1 of Issuer 2 Non-Insider of Issuer (2) R.O.C. Person or Entity Foreign Investor Approved by R.O.C. authorities pursuant to the Regulations Governing Securities Investment by Overseas Chinese and Foreign Nationals. or Foreign Investor Approved by R.O.C. authorities pursuant to the Statute for Investment by Foreign Nationals or Statute for Investment by Overseas Chinese (a "FIA Investor") 3. e. ADR issuance instructions DTC participant no. and account no. Account name Contact person 1 1 A person or entity is deemed to be an "Insider" of Issuer if the person or entity is a director, supervisor, manager or shareholder holding more than 10% of the share capital of Issuer. Any Insider's spouses, minor children or nominees are also deemed as "Insiders". 2 1 If Depositor is an Insider, a copy of the approval for deposit from the R.O.C. Securities and Futures Commission must be delivered to the Depositary and the Local Custodian together with submission of the Deposit Request. 3 / If Depositor is a FIA Investor, the approvals for deposit from the Investment Commission, the Ministry of Economic Affairs or other R.O.C. authorities and the R.O.C. Securities and Futures Commission must be delivered to the Depositary and the Local Custodian together with submission of the Deposit Request.

4 2. Information for Purchase / Issue request (the total number of Taiwan Shares requested to be purchased, when combined with any Taiwan Shares intended to be deposited under 3 below must equal or exceed 50,000 Taiwan Shares. If less than the requested number of Taiwan Shares are purchased, all such whole lots purchased will be deposited to create ADSs, even if the total number to be deposited is fewer than 50,000 Taiwan Shares) f. Number of Taiwan Shares Requested to be purchased (a multiple of whole lot shares, i.e. 1,000 shares) Taiwan Shares (represents ADSs) g. Selected Taiwan Broker (request will be rejected if left blank) h. Pre-Advice Remittee bank Amount remitted Value date i. Repatriation remittance instruction Remittee bank SWIFT code Correspondence bank Correspondence bank SWIFT code Requester's A/C No. Beneficiary j. DR issuance instructions DTC participant no. and account no. Account name Contact person

5 3. Information for Deposit / Issue request: (the total number of Taiwan Shares intended to be deposited, when combined with any Taiwan Shares requested to be purchased under 2 above must equal or exceed 50,000 Taiwan Shares. As long as the total number of Taiwan Shares requested to be purchased under 2 above along with those requested to be deposited under this section 3 totals or exceeds 50,000 Taiwan Shares, all such Taiwan Shares so purchased under 2 above and all Taiwan Shares sought to be deposited under this section 3, so long as a whole lot, will be deposited to create ADSs.) f. Number of Taiwan Shares Deposited (a multiple of whole lot shares, i.e. 1,000 shares) g. Taiwan Broker/Custodian h. TDCC account no. Taiwan Shares (represents ADSs) II. PROCEDURES This request shall be faxed by the Requestor to the Depositary at: JPMORGAN CHASE BANK, DELAWARE OPERATIONS Fax No.: or (back-up line) Notes:(i) (ii) PRIOR TO FAXING REQUEST, REQUESTOR MUST HAVE IN PLACE WITH THE DEPOSITARY A SIGNED PROCEDURES LETTER. THE DEPOSITARY SHALL HAVE NO OBLIGATION TO ACT UPON THIS REQUEST UNLESS ALL ITEMS HEREIN ARE COMPLETE AND UNAMBIGUOUS AND THIS REQUEST IS SIGNED BY AN AUTHORIZED PERSON. Ill. INDEMNITY The Requestor agrees to indemnify the Depositary, the Local Custodian, each affiliate thereof and the officers, employees and agents of each of them, and to hold each harmless, against all cost, liabilities and expenses, including (without limitation) any legal fees and disbursements, arising directly or indirectly from the inaccuracy of any information provided by the Requestor in the Request or the actions taken or omitted to be taken by them pursuant to this request.

6 IV. GOVERNING LAW AND JURISDICTION This Request shall be governed by and construed in accordance with the laws of the State of New York, the United States of America. This Request is made as of the date first above written. (insert name of Requestor) By: Name: Title: