1 APPLICATION FORM To Mr Pascal Diaz, chairman of by usr10478

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									European Composite Recycling Services Company SCRL

                                                        Bd. Auguste Reyers 80, Diamant Building – 1030 Brussels
                                                          Legal entities register – Brussels – VAT BE 865.375.897


                                            APPLICATION FORM



To Mr Pascal Diaz, chairman of the board of directors of the cooperative company with limited
liability European Composite Recycling Services Company, having its registered office in 1030
Brussels, Bd. Auguste Reyers 80, Diamant Building (in short “ECRC”)

Once duly filled in, this form should be sent to:

           Mr Pascal Diaz
           Chairman ECRC
           c/o [Company]
           Immeuble le Berlioz, Domaine de la gare, 07100 – Annonay, France
           Fax: 00 33 (0) 475 34 24 29


The undersigned:

Name:

Registered Office:          street / no :

                            City / P.O.
                            box        /
                            Postcode:

                            Country:

Details:                    Tel. :

                            Fax :

                            E-mail :

Legal Form:

Enterprise Number:

VAT Number:

Represented by:             Name:                                and        Name:

                            Title:                                          Title:

is a legal entity which is active in the FRP value chain as defined in Article 17 of the articles of
association of ECRC.

In addition, the applying entity declares, represents, acknowledges, agrees and undertakes as
follows:

(1) The applying entity is validly represented as set out hereabove, in accordance with [article [•] of
its articles of association / the special power of attorney], attached hereto.

(2) The applying entity acknowledges that it has received and carefully read the articles of
association of ECRC and, if applicable, its internal regulation, and submits through this form its
application to receive the approval of the board of directors of ECRC, in accordance with articles
10 and 19 of the articles of association and the internal regulation.




A04795578/0.4/08 Feb 2005
                                                    1
European Composite Recycling Services Company SCRL

                                                                 Bd. Auguste Reyers 80, Diamant Building – 1030 Brussels
                                                                   Legal entities register – Brussels – VAT BE 865.375.897

(3) For information purposes only, the applying entity proposes to the board of directors to rank it
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within the following category of the FRP value chain :

                  glass fibre suppliers category

                  resin suppliers category

                  compounders category

                  moulders category

                  category of other active in the FRP value chain

(4) The total turnover of the applying entity in the FRP business over 2004 amounts to EUR
______________________. Therefore, the applying entity undertakes to pay the system fee
corresponding to the category number [•], pursuant to the decision of the board of directors of
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ECRC of 11 May 2004 (for the period ending on 30 June 2005) .

(5) The applying entity agrees and undertakes:

[ (SUBSCRIPTION ALTERNATIVE)

under the condition precedent of the approval of the board of directors of ECRC in accordance
with Articles 10 and 19 of the articles of association, to subscribe for


           3
Number :              1               new share of ECRC

at a nominal value of                    100                        euros per share,



and to immediately and entirely pay up the subscribed share, as required by Article 10 of the
articles of association of ECRC, by wire transfer of the amount of 100 euro (without any deduction
for wire transfer costs or administrative fees) to the following special account of the company,
designated in accordance with Article 422, second paragraph, of the Belgian Companies Code:

Bank account: ______ - _______________________ - ______ at [Bank]

IBAN: ______ - ______ - ______ - ______

BIC (SWIFT CODE): ___________________ ]

[ OR (TRANSFER ALTERNATIVE)




1
    Please tick off the category of your choice.
2
    Extract from the board decision of 11 May 2004 (valid until 30 June 2005). Please select the relevant category:
                  Cat.                 Company turnover(*106 Euro)                           Annual fee
                                                                                             (Euro)
                  1                                        > 100                             15.000
                  2                                       50 – 100                           10.000
                  3                                       25 – 50                             5.000
                  4                                       10 – 25                             2.500
                  5                                         < 10                              1.000

3
    This number shall correspond to the number set by the board of directors on an annual basis, in accordance with Art. 10
    of the articles of association of the ECRC.



A04795578/0.4/08 Feb 2005
                                                             2
European Composite Recycling Services Company SCRL

                                                                   Bd. Auguste Reyers 80, Diamant Building – 1030 Brussels
                                                                     Legal entities register – Brussels – VAT BE 865.375.897

under the condition precedent of the approvals of the board of directors of ECRC, in accordance
with Articles 9, 10 and 19 of the articles of association to acquire
            4
Number :             1                outstanding share of ECRC

the nominal value of which amounts to:                100            euros per share.



This outstanding share currently belongs to

Name:

Registered office:

Legal form:

Enterprise number:

An extract of the share transfer agreement, entered into under condition precedent of the approval
of the board of directors (“transfer declaration”), is attached to this form. ]




Executed in:

On:


Name:




represented by:


Signature:                                                         Signature:

Name:                                                              Name:

Title:                                                             Title:




Annex:

1.          Articles of association of the applying entity and publication of representation powers

            or

            Articles of association of the applying entity and publication of representation powers and
            special power

[2.         Transfer Declaration]


4
      This number shall correspond to the number set by the board of directors on an annual basis, in accordance with Art. 10
      of the articles of association of the ECRC.



A04795578/0.4/08 Feb 2005
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