Announcement PDF Form 603 Corporations Act 2001 Section 671B Notice of initial substantial holder To Company Name/Scheme Imagion Biosystems Limited ACN/ARSN ACN 616 305 027 1. Details of substantial holder (1) Name Imagion Biosystems Limited ACN 616 305 027 ACN/ARSN (if applicable) As above The holder became a substantial holder on 2. 21 June 2017 Details of voting power The total number of votes attached to all the voting shares in the company or voting interests in the scheme that the substantial holder or an associate (2) had a relevant interest (3) in on the date the substantial holder became a substantial holder are as follows: Class of securities (4) Ordinary Shares 3. Person’s votes (5) Number of securities 112,533,378 Voting power (6) 112,533,378 55.23% Details of relevant interests The nature of the relevant interest the substantial holder or an associate had in the following voting securities on the date the substantial holder became a substantial holder are as follows: Holder of relevant interest Imagion Biosystems Limited 4. Nature of relevant interest (7) Deemed relevant interest under section 608(1)(c) of the Corporations Act, arising from the restriction on the disposal of shares under ASX Restriction Agreements disclosed in Imagion Biosystems Limited's Replacement Prospectus dated 30 May 2017. See Annexure B for a copy of the pro-forma Appendix 9A of the ASX Listing Rules for the form of the ASX Restriction Agreement. Imagion Biosystems Limited has no right to acquire or dispose of these shares, or to control the voting rights attaching to these shares. Class and number of securities 112,533,378 Ordinary Shares Details of present registered holders The persons registered as holders of the securities referred to in paragraph 3 above are as follows: Holder of relevant interest Imagion Biosystems Limited 5. Registered holder of securities Those holders listed in Annexure A Person entitled to be registered as holder Class and number of securities (8) Those holders listed in Annexure A 112,533,378 Ordinary Shares Consideration The consideration paid for each relevant interest referred to in paragraph 3 above, and acquired in the four months prior to the day that the substantial holder became a substantial holder is as follows: No consideration was paid by Imagion Biosystems Limited. Imagion Biosystems Limited has no right to acquire these shares that are subject to the escrow arrangements, as noted in paragraph 3 above. 6. Associates The reasons the persons named in paragraph 3 above are associates of the substantial holder are as follows: Name and ACN/ARSN (if applicable) Nature of association N/A N/A 7. Addresses The addresses of persons named in this form are as follows: Name Imagion Biosystems Limited Address Level 8, 555 Bourke Street, Melbourne VIC 3000 Holders listed in Annexure A Refer to Annexure A 1 Signature print name Jovanka Naumoska sign here capacity Company Secretary date 20 July 2017 DIRECTIONS (1) If there are a number of substantial holders with similar or related relevant interests (eg. a corporation and its related corporations, or the manager and trustee of an equity trust), the names could be included in an annexure to the form. If the relevant interests of a group of persons are essentially similar, they may be referred to throughout the form as a specifically named group if the membership of each group, with the names and addresses of members is clearly set out in paragraph 7 of the form. (2) See the definition of "associate" in section 9 of the Corporations Act 2001. (3) See the definition of "relevant interest" in sections 608 and 671B(7) of the Corporations Act 2001. (4) The voting shares of a company constitute one class unless divided into separate classes. (5) The total number of votes attached to all the voting shares in the company or voting interests in the scheme (if any) that the person or an associate has a relevant interest in. (6) The person’s votes divided by the total votes in the body corporate or scheme multiplied by 100. (7) Include details of: (a) any relevant agreement or other circumstances by which the relevant interest was acquired. If subsection 671B(4) applies, a copy of any document setting out the terms of any relevant agreement, and a statement by the person giving full and accurate details of any contract, scheme or arrangement, must accompany this form, together with a written statement certifying this contract, scheme or arrangement; and (b) any qualification of the power of a person to exercise, control the exercise of, or influence the exercise of, the voting powers or disposal of the securities to which the relevant interest relates (indicating clearly the particular securities to which the qualification applies). See the definition of "relevant agreement" in section 9 of the Corporations Act 2001. (8) If the substantial holder is unable to determine the identity of the person (eg. if the relevant interest arises because of an option) write “unknown.’” (9) Details of the consideration must include any and all benefits, moneys and other, that any person from whom a relevant interest was acquired has, or may, become entitled to receive in relation to that acquisition. Details must be included even if the benefit is conditional on the happening or not of a contingency. Details must be included of any benefit paid on behalf of the substantial holder or its associate in relation to the acquisitions, even if they are not paid directly to the person from whom the relevant interest was acquired. 2 This is Annexure A of 6 pages referred to in ASIC Form 603 (Notice of Initial Substantial Holder) lodged by Imagion Biosystems Limited ACN 616 305 027. Signed: __________________________ Jovanka Naumoska Company Secretary Dated: 20 July 2017 Registered Holder Mr Kemper Shaw Mr Kemper Shaw Weiner Pty Ltd William Taylor Nominees Pty Ltd Altinova Nominees Pty Ltd Gleneagle Asset Management <Alium Alpha Fund A/C> Mr Todd John Hoare Spring Sydney Pty Ltd C & R Maher Pty Ltd <The C&R Maher Family A/C> Mr Andrew Justin Walsh LTL Capital Pty Ltd <LTL Capital A/C> Mr Michael Francis Correa Mr Scott Philip Kirkland Address 1,425,930 Ordinary Shares Escrowed 12 Months from Date of Admission 0 Ordinary Shares Escrowed 12 Months to 7 Feb 2018 1,425,930 954,548 0 954,548 0 340,850 0 340,850 0 2,380,478 0 2,380,478 0 122,727 0 122,727 0 1,020,059 0 1,020,059 0 2,377,941 0 2,377,941 0 61,363 0 61,363 0 20,454 0 20,454 0 20,455 0 20,455 0 409,091 0 409,091 0 20,454 0 20,454 0 67,500 0 67,500 0 TOTAL ORDINARY SHARES SUBJECT TO ESCROW PO Box 656 BONDI JUNCTION NSW 1355 PO Box 656 BONDI JUNCTION NSW 1355 PO Box 656 BONDI JUNCTION NSW 1355 PO Box 656 BONDI JUNCTION NSW 1355 Level 2, 66 Hunter Street SYDNEY NSW 2000 Level 8 Kyle House 27-31 Macquarie Place SYDNEY NSW 2000 432 Bourke Street SURRY HILLS NSW 2010 9/203 Birrell Street WAVERLEY NSW 2024 4/73 Wallaroy Road WOOLLAHRA NSW 2025 143 Queen Street WOOLLAHRA NSW 2025 16 Murriverie Road NORTH BONDI NSW 2026 18 Vaucluse Road VAUCLUSE NSW 2030 1 Greenwood Avenue SOUTH COOGEE NSW 2034 1 Ordinary Shares Escrowed 24 Months from Quotation 0 Vulture Fish Pty Ltd Fordham Speers Pty Ltd <Fordham Speers S/F A/C> Dojo Holdings Pty Ltd <Squire Family A/C> Raya Investments Pty Ltd <Raya A/C> Ms Charlote Corbett Bridgeview Trading Pty Ltd Walsh Prestige Pty Ltd <Walsh Family A/C> Drapua Capital Pty Ltd Sto Capital Pty Ltd Big Oat Pty Ltd Mr Kiril Dennis Boitcheff & Mrs Suzanne Janet Boitcheff <Seaview Super Fund A/C> Asenna Wealth Solutions Pty Ltd Asenna Wealth Solutions Pty Ltd Mr Michele Chiodo Healthville Investments Pty Ltd <Dr Robert Chiodo A/C> Arision Pty Ltd <Jare Super Fund A/C> Mr Robert William Proe Frimate Pty Ltd Tuff Turf Pty Ltd Mr Michael Richard Porter & Mrs Patricia Mary Porter Mr Joshua Mason Chadwick Paul Edric O'Hanlon 401/57 Upper Pitt Street KIRRIBILLI NSW 2061 7 Cairo Street CAMMERAY NSW 2062 13 Alan Avenue SEAFORTH NSW 2092 2 Magnolia Lane SEAFORTH NSW 2092 14 Bella Vista Court WARRIEWOOD NSW 2102 2501/1 Australia Avenue SYDNEY OLYMPIC PARK NSW 2127 38 Bundilla Parade BERKELEY VALE NSW 2261 31 Sandpiper Drive BURLEIGH WATERS QLD 4220 31 Sandpiper Drive BURLEIGH WATERS QLD 4220 203 Wattle Street MALVERN SA 5061 PO Box 424 VIRGINIA SA 5120 Level 7 564 St Kilda Road MELBOURNE VIC 3004 Level 7 564 St Kilda Road MELBOURNE VIC 3004 PO Box 261 GREENSBOROUGH VIC 3088 PO Box 261 GREENSBOROUGH VIC 3088 PO Box 3078 DONCASTER EAST VIC 3109 8 Fellows Street HUGHESDALE VIC 3166 PO Box 272 ELSTERNWICK VIC 3185 47 Shearson Crescent MENTONE VIC 3194 1 Durham Street NEWINGTON VIC 3350 4 Bramall Street EAST PERTH WA 6004 8/135 Royal Street EAST PERTH WA 6004 2 225,000 0 225,000 0 20,454 0 20,454 0 81,818 0 81,818 0 143,100 0 143,100 0 20,454 0 20,454 0 143,100 0 143,100 0 157,500 0 157,500 0 22,500 0 22,500 0 22,500 0 22,500 0 22,500 0 22,500 0 81,900 0 81,900 0 1,431,818 0 1,431,818 0 916,604 0 916,604 0 604,562 0 604,562 0 604,856 0 604,856 0 2,052,128 0 2,052,128 0 401,632 0 308,250 93,382 81,818 0 81,818 0 127,727 0 127,727 0 81,818 0 81,818 0 8,181 0 8,181 0 73,620 0 73,620 0 Derek Anthony Barlow <Barlow Family A/C> Brooksbury Pty Ltd <The Coxon Super Fund A/C> Busso Holdings Pty Ltd <Bew A/C> Mr Brian Cole Yardie (WA) Pty Ltd <Aw Smith Family A/C> Mac Equity Partners (International) Pty Ltd Pheakes Pty Ltd <Senate A/C> Burley WA Pty Ltd <Burley Investment A/C> Mr Timothy Burley Chapman Mr Michael Grove & Mrs Jane Grove <Gladgrove Super Fund A/C> Leisurewest Consulting Pty Ltd <Leisurewest A/C> Blue Albatross Pty Ltd Mr Richard Hugo Hamersley Mr Richard Hugh Hamersley Thomas James Loh Benjamin Llewelyn Moss Mr Richard George Douglas Reading Mr Richard Reading Tejiman Holdings Pty Ltd Terence William Joseph Walsh Riverview Corporation Pty Ltd Hilary Somerville Statham & Thomas Charles Statham <Merlin Super Fund A/C> Mrs Hilary Somerville Stratham & Mr Thomas 18 View Street SUBIACO WA 6008 PO Box 8104 SUBIACO EAST WA 6008 96 Olive Street SUBIACO WA 6008 225 Hamersley Road SUBIACO WA 6008 24 Jasmine Avenue SUBIACO WA 6008 PO Box 3096 Broadway NEDLANDS WA 6009 81 Philip Road DALKEITH WA 6009 32A Mayfair Street MOUNT CLAREMONT WA 6010 25 Reeve Street SWANBOURNE WA 6010 10 Wood Street SWANBOURNE WA 6010 90 Clement Street SWANBOURNE WA 6010 37 Napier Street COTTESLOE WA 6011 37 Napier Street COTTESLOE WA 6011 37 Napier Street COTTESLOE WA 6011 7 Greenham Street COTTESLOE WA 6011 8 Sea View Terrace COTTLESLOE WA 6011 6 Henry Road COTTESLOE WA 6011 6 Henry Road COTTESLOE WA 6011 23A View Street PEPPERMINT GROVE WA 6011 18 Irvine Street PEPPERMINT GROVE WA 6011 3 Minim Close MOSMAN PARK WA 6012 20 Fairlight Street MOSMAN PARK WA 6012 142,837 0 142,837 0 40,909 0 40,909 0 49,091 0 49,091 0 163,636 0 163,636 0 402,272 0 102,272 300,000 14,567 0 0 14,567 114,525 0 114,525 0 40,909 0 40,909 0 72,371 0 0 72,371 187,060 0 187,060 0 203,704 0 203,704 0 203,977 0 203,977 0 183,270 0 183,270 0 122,727 0 122,727 0 40,909 0 40,909 0 40,909 0 40,909 0 40,909 0 40,909 0 187,204 0 187,204 0 102,272 0 102,272 0 102,272 0 102,272 0 102,273 0 102,273 0 81,818 0 81,818 0 20 Fairlight Street 122,222 0 122,222 0 3 Charles Stratham <Merlin Super Fund A/C> MOSMAN PARK NSW 6012 Mr Hugh James Pilgrim 95 Birkdale Street FLOREAT WA 6014 95 Birkdale Street FLOREAT WA 6014 21 North Banff Road FLOREAT WA 6014 Unit 17 16 Perina Way CITY BEACH WA 6015 4 Clovelly Road CITY BEACH WA 6015 48 Buntine Road WEMBLEY DOWNS WA 6019 2/82 Dover Road SCARBOROUGH WA 6019 17 Geordie Rise SORRENTO WA 6020 Suite 10 16 Brodie Hall Drive BENTLEY WA 6102 Unit 3 6 Strickland Street SOUTH PERTH WA 6151 2B Fraser Road APPLECROSS WA 6153 18B Tain Street APPLECROSS WA 6153 Unit 8 17 Amherst Street FREMANTLE WA 6160 Unit 8 17 Amherst Street FREMANTLE WA 6160 9 Quadrant Rise HALLS HEAD WA 6210 RMB 1347C Grange Road BRIDGETOWN WA 6255 RMB 1347C Grange Road BRIDGETOWN WA 6255 PO Box 10477 KALGOORLIE WA 6433 PO Box 1458 WEST PERTH WA 6872 PO Box 1526 SUBIACO WA 6904 Mrs Maria Noreen Pilgrim Mr David James Wall <The Reserve A/C> Straight Lines Holdings Pty Ltd Zerrin Investments Pty Ltd Chelsea Investments (WA) Pty Ltd Mr Alexander Bevington Rovira Mrs Megan Leanne Johnson Jetmax Trading Pty Ltd Mr Shannon Michael Coleman Allview Holdings Pty Ltd Moss Wood Holdings Pty Ltd <Moss Wood Super Fund A/C> JP Security Holdings Pty Ltd <JP A/C> JP Security Holdings Pty Ltd <Cj Security Holdings A/C> Nicholas John Levis & Kerry Ivy Levis <Nj & Ki Levis Super A/C> Boston Legal Services Pty Ltd <Unit A/C> Kamala Holdings Pty Ltd <Asten Discretionary A/C> Greensea Investments Pty Ltd Oofy Prosser Pty Ltd <Drones Family A/C> Covert Force Pty Ltd <The Munga S/F A/C> 4 33,359 0 16,363 16,996 20,454 0 20,454 0 114,525 0 114,525 0 204,545 0 204,545 0 97,950 0 97,950 0 97,950 0 97,950 0 72,371 0 0 72,371 325,864 0 325,864 0 81,818 0 81,818 0 46,841 0 46,841 0 81,818 0 81,818 0 97,934 0 97,934 0 204,545 0 204,545 0 145,957 0 0 145,957 20,454 0 20,454 0 40,741 0 40,741 0 57,272 0 57,272 0 40,909 0 40,909 0 40,909 0 40,909 0 30,550 0 30,550 0 Mr Brent David Coxon <Sokan Disc A/C> Justin Gilmour & Justine Gilmour <Gilmour Super A/C> Pamplona Capital Pty Ltd Pamplona Investments Pty Ltd 6466 Investments Pty Ltd Mr Ryan Michael Laws Unified Power Solutions Pty Ltd Termco Pty Ltd New World Resources Investment Pte Ltd Alitime Nominees Pty Ltd <Honeyham Family A/C> Mr Jack Lloyd Greenwood Ms Michelle Suzanne Quinsee Kybra Capital Pty Ltd Cityscape Asset Pty Ltd <Cityscape Family A/C> Mr John Nolan Dragon Gas Limited Mr Toby Chandler Mr Scott Riley PO Box 1526 SUBIACO WA 6904 PO Box 258 SUBIACO PO WA 6904 PO Box 1526 SUBIACO WA 6904 PO Box 1526 SUBIACO WA 6904 PO Box 752 COTTESLOE WA 6911 PO Box 5394 EAST VICTORIA PARK WA 6981 PO Box 5394 EAST VICTORIA PARK WA 6981 PO Box 313 WELSHPOOL DC WA 6986 Level 32 126 Phillip Street SYDNEY NSW 2000 PO Box 8292 SOUTH PERTH WA 6151 34 Hampton Street SOUTH PERTH WA 6151 Mailpoint 44 280 Bannister Road CANNING VALE WA 6155 Unit 8 17 Amherst Street FREMANTLE WA 6160 PO Box Z5467 PERTH ST GEORGES TCE WA 6831 PO Box 22630 DUBAI UNITED ARAB EMIRATES Suite 701 7th Floor 6-8 Pottinger Street CENTRAL HONG KONG 91 St Stephens Avenue Parnell AUCKLAND 1052 NEW ZEALAND 6 Carriorn Court Apt 703 SAN JUAN 0911 PUERTO RICO 5 26,474 0 26,474 0 40,905 0 40,905 0 203,664 0 203,664 0 1,067,360 0 0 1,067,360 81,818 0 81,818 0 16,996 0 0 16,996 45,000 0 45,000 0 97,949 0 97,949 0 2,045,455 0 2,045,455 0 114,525 0 114,525 0 47,250 0 47,250 0 97,706 0 97,706 0 81,900 0 81,900 0 877,303 0 877,303 0 409,091 0 409,091 0 40,909 0 40,909 0 6,100,000 0 0 6,100,000 203,316 0 203,316 0 Maunsell Global Corporation Mr Craig Nicholas Sloane Mr Ferdinand J Crovato <Ferdinand J Crovato A/C> Mr Anthony Faillace Mingxiong Huang Mr William B Jones Manhattan Scientifics Inc Mr Raymond A Mason Mr Robert Reveley Mr Robert C Verfurth & Mrs Serena C Verfurth 6 Jiak Chuan Road #02-01 089262 SINGAPORE 7C Tong Watt Road 238104 SINGAPORE 1201 Stuart Robeson Drive MCLEAN VIRGINIA 22101 USA 954 Lexington Avenue #149 NEW YORK 10021 USA 13112 Sienna Court SAN DIEGO CALIFORNIA 92129 USA 793 17 Ave S NAPLES FLORIDA 3410 USA The Chrysler Building 26th Floor 405 Lexington Avenue NEW YORK NY 10174 USA 880 Spyglass Lane NAPLES FLORIDA 34102 USA PO Box 3418 Manhattan Beach CA 90266 USA 12539 Via Colmenar San Diego CA 92129 USA TOTALS 6 254,906 0 254,906 0 20,454 0 20,454 0 1,111,111 1,111,111 0 0 5,403,557 0 5,403,557 0 150,000 150,000 0 0 1,111,111 1,111,111 0 0 64,099,476 0 0 64,099,476 1,111,111 1,111,111 0 0 6,100,000 0 0 6,100,000 407,182 0 407,182 0 112,533,378 3,483,333 30,950,569 78,099,476 This is Annexure B of 4 pages referred to in ASIC Form 603 (Notice of Initial Substantial Holder) lodged by Imagion Biosystems Limited ACN 616 305 027. Signed: __________________________ Jovanka Naumoska Company Secretary Dated: 20 July 2017 1 Appendix 9A Restriction agreement Appendix 9A Restriction agreement Introduced 01/07/96 Origin: Appendix 11 Amended 01/07/98, 11/03/02, 24/10/05, 20/07/07 We, the persons in: • Item 1 of the schedule (“entity”); • Item 2 of the schedule (“holder”); • Item 3 of the schedule (“controller”), agree as follows. Introduction *A. The entity intends to issue restricted securities to the holder. The holder will hold the restricted securities as set out in this agreement. It is a condition of the issue of the restricted securities that we will comply with this agreement. *A. The entity wants to be listed and has issued restricted securities. The holder will hold the restricted securities as set out in this agreement on the basis that the entity will take the steps necessary to be admitted to the +official list of ASX. B. We have provided ASX with all the information necessary to properly form an opinion about who is a +controller of the holder and who is required to execute this agreement. C. We enter this agreement for the purpose of complying with chapter 9 of the listing rules. (* delete as applicable) Agreement Escrow restrictions 1. During the escrow period, the holder will not do any of the following. (a) +Dispose of, or agree or offer to +dispose of, the restricted securities. + See chapter 19 for defined terms. 04/03/2013 Appendix 9A Page 1 Appendix 9A Restriction agreement (b) Create, or agree or offer to create, any security interest in the restricted securities. (c) Do, or omit to do, any act if the act or omission would have the effect of transferring effective ownership or control of the restricted securities. (d) Participate in a return of capital made by the entity. Amended 24/10/05 2. During the escrow period, a controller will not do any of the following. (a) +Dispose of, or agree or offer to +dispose of, the controller interests. (b) Create, or agree or offer to create, any security interest in the controller interests. (c) Do, or omit to do, any act if the act or omission would have the effect of transferring effective ownership or control of the controller interests. 3. We will comply with chapter 9 of the listing rules. If any of us is not a listed entity, we will comply as if we were a listed entity. Each of us will take any steps we are able to take that are necessary to enable any of the others to comply. 4. (a) If the restricted securities are kept on the +certificated subregister, the holder will deposit the certificates for the restricted securities with a bank or +recognised trustee for the escrow period. (b) If the restricted securities are kept on the +issuer sponsored subregister, the holder hereby agrees in writing to the application of a +holding lock to the restricted securities. Warranties 5. If only the holder and the entity are parties to this agreement, one of the following applies. (a) The holder is an individual. (b) The holder has no +controller. (c) The holder has the +controllers set out in item 3 with the interests identified in item 6, and each +controller comes within an exception set out in rule 9.1.4. + See chapter 19 for defined terms. 04/03/2013 Appendix 9A Page 2 Appendix 9A Restriction agreement The holder gives this warranty. 6. If the holder, the entity and any +controller are parties to this agreement, the holder has the +controllers set out in item 3 with the controller interests identified in item 6, and any +controller who is not a party to this agreement comes within an exception set out in rule 9.1.4. The holder and each +controller give this warranty. 7. If item 7 of the schedule is completed, the full particulars of security interests which have been created, or are agreed or offered to be created, in the restricted securities are set out. A release of the security interests is attached. Apart from this, before the escrow period begins, the holder has not done, or omitted to do, any act which would breach clause 1 if done or omitted during the escrow period. The holder gives this warranty. 8. If item 8 of the schedule is completed, the full particulars of security interests which have been created, or are agreed or offered to be created, in the controller interests are set out. A release of the security interests is attached. Apart from this, before the escrow period begins, the +controller has not done, or omitted to do, any act which would breach clause 2 if done or omitted during the escrow period. Each +controller gives this warranty. 9. A breach of any of these warranties is a breach of this agreement. Consequences of breaching this agreement 10. If it appears to the entity that the holder or a +controller may breach this agreement, the entity must take the steps necessary to prevent the breach, or to enforce the agreement. 11. If the holder or a +controller breach this agreement, each of the following applies. (a) The entity must take the steps necessary to enforce the agreement, or to rectify the breach. (b) The entity must refuse to acknowledge, deal with, accept or register any sale, assignment, transfer or +conversion of any of the +restricted securities. This is in addition to other rights and remedies of the entity. (c) The holder of the +restricted securities ceases to be entitled to any dividends, distributions or voting rights while the breach continues. Amendment 12. This agreement will not be changed or waived without ASX’s written consent. + See chapter 19 for defined terms. 04/03/2013 Appendix 9A Page 3 Appendix 9A Restriction agreement Jurisdiction 13. The laws of the State of the home branch of the entity apply to this agreement. We submit to the jurisdiction of the courts of that State. Definitions and interpretation In this agreement: ASX means ASX Limited. controller interests means the +securities, substantial economic interest or other interests in the restricted securities and each intermediate entity through which that interest occurs, full particulars of which are set out in item 6 of the schedule. escrow period means the period set out in item 4 of the schedule. restricted securities means the +securities set out in item 5 of the schedule and any +securities attaching to or arising out of those +securities that are restricted securities because of the definition of restricted securities in the listing rules. The singular includes the plural and vice versa. A reference to a party includes its successors, personal representatives and transferees. Words and expressions defined in the listing rules of ASX, and not in this agreement, have the meanings given to them in the listing rules. Every warranty or agreement (expressed or implied) in which more than one person joins, binds them individually and any combination of them as a group. Schedule 1. Entity’s name and address: 2. Holder’s name and address: 3. Each +controllers’ name and address: 4. Escrow period (the date from which the initial restricted securities are escrowed): 5. Particulars of restricted securities: 6. Particulars of controller interests: 7. Particulars of security interests over restricted securities: 8. Particulars of security interests over controller interests: Dated: [Proper execution as a deed] + See chapter 19 for defined terms. 04/03/2013 Appendix 9A Page 4