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Reporting Equity Capital - Status of Shares (relevant for companies with secondary listing)

Alternatively, this form may be sent to the SIX Swiss Exchange by fax or post.

 * Mandatory fields
  
Name of the company*
Last name*
First name*
E-mail*
Phone*

Reporting requirements pursuant to the
Directive on the Listing of Foreign Companies, Art. 19 para. 2

Reporting of the current number of quoted shares

Title category*
ISIN*

The abovementioned company is listed on the following primary exchange*
 
Status as of the end of*
Number of shares*
Currency*
Nominal Value*