股票挂失申请书

股票挂失申请书 股票掛失申請書 Application of Stock Loss Registration 中華民國 年 月 日(Date of Application) 本股東持有 股份有限公司下列股票因遺失,檢附治安機關報案書乙紙請先惠予登記 掛失,俟本人依法向法院聲請公示催告,並取得除權判決書之後,再請惠予補發新股票為荷。 此致 Due to loss or destruction of stock certificate(s) mentioned below, I/ we, owner(s) of such stock(s), hereby attach a copy of correspondence provided by police office and apply to your company for stock loss registration. 股份有限公司股務部( Corporation, Stock Affairs Department) 股票種類 張數 股數 股票字號 stock certificate code sort of stock Piece(s) number of share 合計Total 股東戶號, 住址, (原留印鑑, Shareholder Account No. Address Stamp with Specimen chop 股東戶名, 電話, Shareholder’s Name Tel. No. 身分證字號, ID No. 主 經 核 管 辦印 股 失 字 第 號