WE’RENOTREALLYHERE SHAREHOLDER REPAYMENT.

To claim your shareholder repayment you need provide us with the information requested then we will repay direct into your bank account within 30 days.

Please complete the form with your bank details and we will forward your repayment.

Tel : 07973 309951

Name

First Name

Last Name

Share number

Bank Account Name

Sort Code

Account Number

Date of Purchase

WE’RENOTREALLYHERE SHAREHOLDER REPAYMENT.

Blue Moon Racing