Image Registrars Ltd™

Mandate Form

Full Name Required*

ID/Passport Number Required*

CDSC No

Certificate No

Country

Postal Address

Postal Code

Town

Mobile Number(254xxxxxxxxx) Required*

E-mail

Payment Method

Shareholder Type

Tax Type

Bank

Bank Code

Bank Branch Required*

Branch Code

Bank Account Required*

International Bank

International Bank Branch

Bank Account

Swift Code

Upload a Copy of ID or Passport

NOTE: If you are a CDS Account holder, please also update your details with your stockbroker. I consent and confirm that the above details are true and correct. I/We authorise Image Registrars Limited to use the information (mobile/bank number) provided only for matters pertaining to my Safaricom shareholding and payment of any outstanding dividend in my/our name(s). I will notify the Registrar should the above information change.

Documents

SAFARICOM PLC OPT-IN PAYMENT FORM

You can also download and submit the attached form to update your details.

Download

Image Registrars Ltd
ABSA TOWERS, 5th floor,Loita Street
Nairobi Kenya
Tel: +254 709 170 000
Email: info@image.co.ke/safaricomshares@image.co.ke

Image Registrars(U) Ltd
Jubilee Insurance Center
Plot 14, Parliament Avenue, 1st Floor
Kampala Uganda
Tel: +256 762 260 804 (MTN)
Email: info@image.co.ke