To register your potential interest in buying Community Shares in the Village Shop and to receive a prospectus, please complete the form below.               Your postcode will be used to verify your entitlement and your indicated investment will help us to gauge the overall level of interest.                         Remember that, for UK taxpayers, the original investment attracts a tax rebate of 30%, effectively reducing the net investment to 70% of the original.                        Please tick your likely original investment.                                 No commitment is made at this point and your information will be treated confidentially for use only in relation to this share offer and not shared with any other party.

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Registration of interest in Community Share allocation

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This form is also available in printed form in the Shop and can be returned there in an envelope to maintain your privacy.

If you choose to send the form online we commit to preserving your privacy and not sharing the information beyond the

responsible officers on the shop main committee. It will be sent to a specially controlled email account.

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ACSA Ltd - listed as Registered Society number 29956R with the Financial Conduct Authority under the Co-operative & Community Benefit Societies Act 2014