Please use this form if you want the Hong Kong Offer Shares to be issued in your name 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 This Application Form uses the same terms as defi ned in the prospectus of Jilin Jiutai Rural Commercial Bank Corporation Limited (“the Bank”) dated December 30, 2016 (the “Prospectus”). 本申请表格使用吉林九台农村商业银行股份有限公司（「本行」）於2016年12月30日刊发的招股书（「招股书」）所界定的词语。 Neither this Application Form nor the Prospectus constitutes an offer to sell or the solicitation of an offer to buy any Hong Kong Offer Shares in any jurisdiction other than Hong Kong. The Hong Kong Offer Shares may not be offered or sold in the United States without registration or an exemption from registration under the U.S. Securities Act. No registration has been or will be made under the U.S. Investment Company Act. 本申请表格及招股书概不构成在香港以外司法权区要约出售或游说要约购买香港发售股份。若无根据美国证券法登记或豁免登记，香港发售股 份不得在美国提呈发售或出售。本行并无且不会根据美国投资公司法登记。 This Application Form and the Prospectus may not be forwarded or distributed or reproduced (in whole or in part) in any manner whatsoever in any jurisdiction where such forwarding, distribution or reproduction is not permitted under the law of that jurisdiction. 在任何根据当地法例不得发送、派发或复制本申请表格及招股书的司法权区内概不得发送、派发或复制（不论方式，也不论全部或部分）本申请 表格及招股书。 Copies of the Prospectus, all related Application Forms and the other documents specifi ed in the “Documents Delivered to the Registrar of Companies and Available for Inspection” section in Appendix VIII to the Prospectus, have been registered by the Registrar of Companies in Hong Kong as required by Section 342C of the Companies (Winding Up and Miscellaneous Provisions) Ordinance (Chapter 32 of the Law of Hong Kong). Hong Kong Exchanges and Clearing Limited, The Stock Exchange of Hong Kong Limited (the “Hong Kong Stock Exchange”), Hong Kong Securities Clearing Company Limited (“HKSCC”), the Securities and Futures Commission of Hong Kong (the “SFC”) and the Registrar of Companies of Hong Kong take no responsibility for the contents of these documents. 招股书、所有相关申请表格及招股书附录八「送呈公司注册处处长及备查文件」一节所述其他文件已遵照香港法例第32章《公司（清盘及杂项条文） 条例》第342C条的规定送呈香港公司注册处处长登记。香港交易及结算所有限公司、香港联合交易所有限公司（「香港联交所」）、香港中央结算有限 公司（「香港结算」）、香港证券及期货事务监察委员会（「证监会」）及香港公司注册处处长对此等文件的内容概不负责。 JILIN JIUTAI RURAL COMMERCIAL BANK CORPORATION LIMITED * 吉林九台农村商业银行股份有限公司* (A joint stock company incorporated in the People’s Republic of China with limited liability) （於中华人民共和国注册成立的股份有限公司） Stock Code : 6122 股份代号 : 6122 Maximum Offer Price : HK$4.76 per H Share (payable in full on application in Hong Kong dollars, subject to refund on final pricing), plus brokerage of 1%, SFC transaction levy of 0.0027% and Hong Kong Stock Exchange trading fee of 0.005% 最高发售价 : 每股H股4.76港元，另加1%经纪佣金、0.0027%证监会交易徵费 及0.005%香港联交所交易费（须於申请时以港元缴足，最终定 价後多缴款项可予退还） You should read this Application Form in conjunction with the Prospectus, which contains further information on the application procedures. 招股书尚有关於申请程序的其他资料，本申请表格应与招股书一并阅读。 To: Jilin Jiutai Rural Commercial Bank Corporation Limited Sole Sponsor Sole Representative Joint Global Coordinators Joint Bookrunners Hong Kong Underwriters Applicants’ declaration I/We agree to the terms and conditions and application procedures in this Application Form and the Prospectus. Please refer to the “Effect of completing and submitting this Application Form” section of this Application Form. Warning: Only one application may be made for the benefi t of any person.Please refer to the last four bullets of “Effect of completing and submitting this Application Form” section. 致： 吉林九台农村商业银行股份有限公司 独家保荐人 独家代表 联席全球协调人 联席账簿管理人 香港承销商 申请人声明 本人�u吾等同意本申请表格及招股书的条款及条件以及申请程 序。请参阅申请表格「填交本申请表格的效用」一节。 警告：任何人士只限作出一次为其利益而进行的认购申请。请 参阅「填交本申请表格的效用」一节最後四点。 Application Form 申请表格 Staple your payment here 请将股款 紧钉在此 * Jilin Jiutai Rural Commercial Bank Corporation Limited is not an authorized institution within the meaning of the Banking Ordinance (Chapter 155 of the Laws of Hong Kong), not subject to the supervision of the Hong Kong Monetary Authority, and not authorized to carry on banking/deposit-taking business in Hong Kong. * 吉林九台农村商业银行股份有限公司并非香港法例第155章 银行业条例所指的认可机构，不受限於香港金融管理局的监 督、亦不获授权在香港经营银行�u接受存款业务。 Sample 样版 Please use this form if you want the Hong Kong Offer Shares to be issued in your name 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 Signed by (all) applicant(s) (all joint applicants must sign): 由（所有）申请人签署（所有联名申请人必须签署）： Date: 日期： �u �u D 日M 月Y 年 Number of Hong Kong Offer Shares applied for (not more than 33,000,000 shares) 申请香港发售股份数目（不超过33,000,000股股份） Total amount 总额 HK$ 港元 For Broker use 此栏供经纪填写 Lodged by 递交申请的经纪 Broker No. 经纪号码 Broker’s Chop 经纪印章 Cheque/banker’s cashier order number 支票�u银行本票号码 Name of bank on which cheque/Banker’s cashier order is drawn (see “How to make your application” section) 兑现支 票�u银行本票的银行名称（见「申请手续」一节） Name in English 英文姓名�u名称 Family name or company name 姓氏或公司名称 Forename(s) 名字 Name in Chinese 中文姓名�u名称 Family name or company name 姓氏或公司名称 Forename(s) 名字 Occupation in English 职业（以英文填写） Names of all other joint applicants in English (if any) 所有其他联名申请人的英文姓名�u名称（如有） 1) 2) 3) Hong Kong Identity Card No./Passport No./Hong Kong Business Registration No.* (Please delete as appropriate) 香港身份证号码�u护照号码�u香港商业登记号码*（请删 除不适用者） Hong Kong Identity Card No./Passport No./Hong Kong Business Registration No. of all other joint applicants*(Please delete as appropriate) 所有其他联名申请人的香港身份证号码�u护 照号码�u香港商业登记号码*（请删除不适用者） 1) 2) 3) Hong Kong address in English and telephone no. (joint applicants should give the address and the telephone number of first-named applicant only) 香港地址（以英文填写）及电话号码（联名申请人只须填写排名首位申请人的地址及电话号码） Telephone No. 电话号码 For Nominees: You will be treated as applying for your own benefi t if you do not complete this section. Please provide an account number or identifi cation code for each (joint) beneficial owner. 由代名人递交：代名人若不填 写本节，是项认购申请将视作为　阁下利益提出。请 填写每名（联名）实益拥有人的账户号码或识别编码。 ADDRESS LABEL 地址标贴(Your name(s)and address in Hong Kong in BLOCK letters 请用英文正楷填写姓名�u 名称及香港地址) For Internal use 此栏供内部使用 Sample 样版 Please use this form if you want the Hong Kong Offer Shares to be issued in your name 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 * (1) An individual must provide his Hong Kong Identity Card number or, if he does not hold a Hong Kong Identity Card, his passport number. A body corporate must provide its Hong Kong Business Registration number. Each joint applicant must provide its or his relevant number. The Hong Kong Identity Card number(s)/passport number(s)/Hong Kong Business Registration number(s) will be transferred to a third party for checking the Application Form’s validity. 个别人士须填写其香港身份证号码或（如非香港身份证持有人）护照号码。法人团体须填 写其香港商业登记号码。每名联名申请人均须提供其相关号码。该等香港身份证号码�u 护照号码�u香港商业登记号码将转交第三方以核实申请表格的有效性。 (2) Part of the Hong Kong Identity Card number/passport number of you or, for joint applicants, the first-named applicant may be printed on your refund cheque (if any). Your banker may require verification of your Hong Kong Identity Card number/passport number before you can cash your refund cheque. 退款支票（如有）或会印有　阁下或（如属联名申请人）排名首位申请人的香港身份证号码�u 护照号码的一部分。银行兑现退款支票前或会要求查证　阁下的香港身份证号码�u护照 号码。 (3) If an application is made by an unlisted company and: the principal business of that company is dealing in securities; and you exercise statutory control over that company, then the application will be treated as being made for your benefit. 倘若申请人是一家非上市公司，而： 该公司主要从事证券买卖业务；及 阁下对该公司可行使法定控制权， 是项申请将视作为　阁下的利益提出。 Sample 样版 This page is intentionally left blank 此乃白页　特意留空 Sample 样版 Please use this form if you want the Hong Kong Offer Shares to be issued in your name How to make your application 1. Use the table below to calculate how much you must pay. Your application must be for a minimum of 1,000 Hong Kong Offer Shares and in one of the numbers set out in the table, or your application will be rejected. NUMBER OF SHARES THAT MAY BE APPLIED FOR AND PAYMENTS No. of Hong Kong Offer Shares applied for Amount payable on application No. of Hong Kong Offer Shares applied for Amount payable on application No. of Hong Kong Offer Shares applied for Amount payable on application No. of Hong Kong Offer Shares applied for Amount payable on application 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000 15,000 20,000 25,000 30,000 4,807.97 9,615.94 14,423.90 19,231.86 24,039.83 28,847.80 33,655.77 38,463.73 43,271.70 48,079.67 72,119.50 96,159.33 120,199.16 144,239.00 35,000 40,000 45,000 50,000 60,000 70,000 80,000 90,000 100,000 200,000 300,000 400,000 500,000 600,000 168,278.83 192,318.66 216,358.49 240,398.33 288,477.99 336,557.66 384,637.32 432,716.99 480,796.65 961,593.30 1,442,389.96 1,923,186.61 2,403,983.26 2,884,779.91 700,000 800,000 900,000 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 6,000,000 7,000,000 8,000,000 9,000,000 10,000,000 20,000,000 3,365,576.56 3,846,373.22 4,327,169.87 4,807,966.52 9,615,933.04 14,423,899.56 19,231,866.08 24,039,832.60 28,847,799.12 33,655,765.64 38,463,732.16 43,271,698.68 48,079,665.20 96,159,330.40 33,000,000 (1) 158,662,895.16 (1) Maximum number of Hong Kong Offer Shares you may apply for. 2. Complete the form in English and sign it. Only written signatures will be accepted (and not by way of personal chop). 3. Staple your cheque or banker’s cashier order to the form. Each application for the Hong Kong Offer Shares must be accompanied by either one separate cheque or one separate banker’s cashier order. Your application will be rejected if your cheque or banker’s cashier order does not meet all the following requirements: The cheque must: Banker’s cashier order must: be in Hong Kong dollars; not be post-dated; be made payable to “BANK OF COMMUNICATIONS (NOMINEE) CO. LTD. ― JIUTAI RCB PUBLIC OFFER”; be crossed “Account Payee Only”; be drawn on your Hong Kong dollar bank account in Hong Kong; and show your account name, which must either be pre-printed on the cheque, or be endorsed on the back by a person authorised by the bank. This account name must correspond with your name. If it is a joint application, the account name must be the same as the firstnamed applicant’s name. be issued by a licensed bank in Hong Kong, and have your name certifi ed on the back by a person authorised by the bank. The name on the banker’s cashier order must correspond with your name. If it is a joint application, the name on the back of the banker’s cashier order must be the same as the first-named applicant’s name. Sample 样版 Please use this form if you want the Hong Kong Offer Shares to be issued in your name 4. Tear off the Application Form, fold it once and lodge your completed Application Form (with cheque or banker’s cashier order attached) to one of the collection boxes at any of the following branches of: Bank of Communications Co., Ltd. Hong Kong Branch District Branch Name Address Hong Kong Island Hong Kong Branch 20 Pedder Street, Central Chai Wan Sub-Branch G/F., 121�C121A Wan Tsui Road, Chai Wan Cinema Building, Chai Wan Kowloon Mongkok Sub-Branch G/F. and 1/F., Shun Wah Building, Nos. 735 & 735A Nathan Road, Mongkok Hunghom Sub-Branch Shop A6, G/F., Whampoa Estate Planet Square, 1�C3 Tak Man Street New Territories Sha Tsui Road Sub-Branch Shops Nos. 3�C5 on G/F., Kwong Ming Building, 120�C130 Sha Tsui Road, Tsuen Wan Tiu Keng Leng Sub-Branch Shops Nos. L2-064 and L2-065, Level 2, Metro Town, Tiu Keng Leng 5. Your Application Form can be lodged at these times: Friday, December 30, 2016 ― 9:00 a.m. to 5:00 p.m. Saturday, December 31, 2016 ― 9:00 a.m. to 1:00 p.m. Tuesday, January 3, 2017 ― 9:00 a.m. to 5:00 p.m. Wednesday, January 4, 2017 ― 9:00 a.m. to 5:00 p.m. Thursday, January 5, 2017 ― 9:00 a.m. to 12:00 noon 6. The latest time for lodging your application is 12:00 noon on Thursday, January 5, 2017. The application lists will be opened between 11:45 a.m.�C12:00 noon on that day, subject only to the weather conditions, as described in “Effect of Bad Weather on the Opening of the Application Lists” in the “How to Apply for Hong Kong Offer Shares” section of the Prospectus. Sample 样版 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 申请手续 1. 使用下表计算　阁下应付的款项。　阁下申请认购的股数须至少为1,000股香港发售股份，并 为下表所列的其中一个数目，否则恕不受理。 可供申请认购股份数目及应缴款项 申请认购的 香港发售 股份数目 申请时 应缴款项 申请认购的 香港发售 股份数目 申请时 应缴款项 申请认购的 香港发售 股份数目 申请时 应缴款项 申请认购的 香港发售 股份数目 申请时 应缴款项 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000 15,000 20,000 25,000 30,000 4,807.97 9,615.94 14,423.90 19,231.86 24,039.83 28,847.80 33,655.77 38,463.73 43,271.70 48,079.67 72,119.50 96,159.33 120,199.16 144,239.00 35,000 40,000 45,000 50,000 60,000 70,000 80,000 90,000 100,000 200,000 300,000 400,000 500,000 600,000 168,278.83 192,318.66 216,358.49 240,398.33 288,477.99 336,557.66 384,637.32 432,716.99 480,796.65 961,593.30 1,442,389.96 1,923,186.61 2,403,983.26 2,884,779.91 700,000 800,000 900,000 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 6,000,000 7,000,000 8,000,000 9,000,000 10,000,000 20,000,000 3,365,576.56 3,846,373.22 4,327,169.87 4,807,966.52 9,615,933.04 14,423,899.56 19,231,866.08 24,039,832.60 28,847,799.12 33,655,765.64 38,463,732.16 43,271,698.68 48,079,665.20 96,159,330.40 33,000,000 (1) 158,662,895.16 (1) 阁下可申请认购的香港发售股份最 高数目。 2. 以英文填妥及签署申请表格。只接纳亲笔签名（不得以个人印章代替）。 3. 阁下须将支票或银行本票钉於表格上。每份香港发售股份申请须附一张独立开出支票或一张 独立开出银行本票。支票或银行本票必须符合以下所有规定，否则有关的认购申请不获接纳： 支票必须： 银行本票必须： 为港元； 不得为期票； 注明抬头人为「交通银行（代理人）有限公司 ― 九台农商银行公开发售」； 划线注明「只准入抬头人账户」； 从　阁下在香港的港元银行账户中开出； 及 显示　阁下的账户名称，而该账户名称必 须已预印在支票上，或由有关银行授权的 人士在支票背书。账户名称必须与　阁下 姓名�u名称相同。如属联名申请，账户名 称必须与排名首位申请人的姓名�u名称相 同。 须由香港持牌银行开出，并由有关银行授 权的人士在银行本票背面签署核证　阁 下姓名�u名称。银行本票所示姓名�u名称 须与　阁下姓名�u名称相同。如属联名申 请，银行本票背面所示姓名�u名称必须与 排名首位申请人的姓名�u名称相同。 Sample 样版 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 4. 请撕下申请表格，对摺一次，然後将填妥的申请表格（连同支票或银行本票）投入下列任何一 家分行特设的收集箱： 交通银行股份有限公司香港分行 地区 分行名称 地址 香港岛 香港分行 中环毕打街20号 柴湾支行 柴湾环翠道121�C121A号柴湾戏院大厦地下 九龙 旺角支行 旺角弥敦道735�C735A号迅华大厦地下及1楼 红�|支行 黄埔新�德民街1�C3号地下A6号�m 新界 沙咀道支行 荃湾沙咀道120�C130号光明大厦地下3�C5号�m 调景岭支行 调景岭都会�k商场2楼L2�C064及L2�C065号�m 5. 阁下可於下列时间递交申请表格： 2016年12月30日（星期五） ― 上午九时正至下午五时正 2016年12月31日（星期六） ― 上午九时正至下午一时正 2017年1月3日（星期二） ― 上午九时正至下午五时正 2017年1月4日（星期三） ― 上午九时正至下午五时正 2017年1月5日（星期四） ― 上午九时正至中午十二时正 6. 截止递交申请的时间为2017年1月5日（星期四）中午十二时正。本行将於当日上午十一时四十五 分至中午十二时正期间登记认购申请，唯一会影响此时间的变化因素为当日的天气情况（详 见招股书「如何申请香港发售股份」一节「恶劣天气对开始办理申请登记的影响」）。 Sample 样版 Please use this form if you want the Hong Kong Offer Shares to be issued in your name JILIN JIUTAI RURAL COMMERCIAL BANK CORPORATION LIMITED * 吉林九台农村商业银行股份有限公司* (A joint stock company incorporated in the People’s Republic of China with limited liability) GLOBAL OFFERING Conditions of your application A. Who can apply 1. You or any person(s) for whose benefi t you are applying must be 18 years of age or older and must have a Hong Kong address. 2. You must be outside the United States, not be a United States Person (as defi ned in Regulation S under the U.S. Securities Act) or a person described in paragraph (h)(3) of Rule 902 of Regulation S and not be a legal or natural person of the PRC. 3. If you are a fi rm, the application must be in the individual members’ names. 4. If you are a body corporate, the application must be signed by a duly authorised offi cer, who must state his representative capacity, and stamped with your corporation’s chop. 5. The number of joint applicants may not exceed 4. 6. Unless permitted by the Hong Kong Listing Rules or any relevant waivers that have been granted by the Hong Kong Stock Exchange, you cannot apply for any Hong Kong Offer Shares if you are: an existing benefi cial owner of Shares in the Bank and/or any of its subsidiaries; a director or chief executive offi cer of the Bank and/or any of its subsidiaries; a connected person (as defi ned in the Hong Kong Listing Rules) of the Bank or will become a connected person of the Bank immediately upon completion of the Global Offering; an associate (as defi ned in the Hong Kong Listing Rules) of any of the above; and have been allocated or have applied for any International Offer Shares or otherwise participate in the International Offering. B. If you are a nominee You, as a nominee, may make more than one application for the Hong Kong Offer Shares by: (i) giving electronic instructions to HKSCC via Central Clearing and Settlement System (“CCASS”) (if you are a CCASS Participant); or (ii) using a WHITEor YELLOW Application Form, and lodge more than one application in your own name on behalf of different beneficial owners. C. Effect of completing and submitting this Application Form By completing and submitting this Application Form, you (and if you are joint applicants, each of you jointly and severally) for yourself or as an agent or a nominee on behalf of each person for whom you act: undertaketo execute all relevant documents and instruct and authorise the Bank and/or the Sole Representative (or its agents or nominees), as agents of the Bank, to execute any documents for you and to do on your behalf all things necessary to register any Hong Kong Offer Shares allocated to you in your name as required by the Articles of Association; agreeto comply with the Companies Ordinance, the Companies (Winding Up and Miscellaneous Provisions) Ordinance and the articles of association of the Bank; confirmthat you have read the terms and conditions and application procedures set out in the Prospectus and in this Application Form and agree to be bound by them; confirmthat you have received and read the Prospectus and have only relied on the information and representations contained in the Prospectus in making your application and will not rely on any other information or representations except those in any supplement to the Prospectus; confirmthat you are aware of the restrictions on the Global Offering in the Prospectus; agreethat none of the Bank, the Selling Shareholders, the Sole Representative, the Joint Global Coordinators, the Sole Sponsor, the Joint Bookrunners, the Joint Lead Managers, the Underwriters, their respective directors, offi cers, employees, partners, agents, advisers and any other parties involved in the Global Offering is or will be liable for any information and representations not in the Prospectus (and any supplement to it); undertakeand confirmthat you or the person(s) for whose benefi t you have made the application have not applied for or taken up, or indicated an interest for, and will not apply for or take up, or indicate an interest for, any Offer Shares under the International Offering nor participated in the International Offering; agreeto disclose to the Bank, the H Share Registrar, the receiving bank, the Sole Sponsor, the Sole Representative, the Joint Global Coordinators, the Joint Bookrunners, the Joint Lead Managers, the Underwriters and/or their respective advisers and agents any personal data which they may require about you and the person(s) for whose benefit you have made the application; if the laws of any place outside Hong Kong apply to your application, agreeand warrantthat you have complied with all such laws and none of the Bank, the Selling Shareholders, the Sole Sponsor, the Sole Representative, the Joint Global Coordinators, the Joint Bookrunners, the Joint Lead Managers and the Underwriters nor any of their respective offi cers or advisers will breach any law outside Hong Kong as a result of the acceptance of your offer to purchase, or any action arising from your rights and obligations under the terms and conditions contained in the Prospectus and this Application Form; agreethat once your application has been accepted, you may not rescind it because of an innocent misrepresentation; agreethat your application will be governed by the laws of Hong Kong; represent, warrantand undertakethat (i) you understand that the Hong Kong Offer Shares have not been and will not be registered under the U.S. Securities Act; and (ii) you and any person for whose benefi t you are applying for the Hong Kong Offer Shares are outside the United States (as defined in Regulation S) or are a person described in paragraph (h)(3) of Rule 902 of Regulation S; warrantthat the information you have provided is true and accurate; agreeto accept the Hong Kong Offer Shares applied for, or any lesser number allocated to you under the application; authorisethe Bank to place your name(s) or the name of the HKSCC Nominees on the Bank’s register of members as the holder(s) of any Hong Kong Offer Shares allocated to you, and the Bank and/or its agents to send any share certifi cate(s) and/or any e-Refund payment instructions and/or any refund cheque(s) to you or the fi rst-named applicant for joint application by ordinary post at your own risk to the address stated on the application, unless you have fulfi lled the criteria set out in “Personal Collection” section in the Prospectus to collect the share certifi cate(s) and/or refund cheque(s) in person; declareand representthat this is the only application made and the only application intended by you to be made to benefi t you or the person for whose benefi t you are applying; understandthat the Bank and the Sole Representative will rely on your declarations and representations in deciding whether or not to make any allotment of any of the Hong Kong Offer Shares to you and that you may be prosecuted for making a false declaration; * Jilin Jiutai Rural Commercial Bank Corporation Limited is not an authorized institution within the meaning of the Banking Ordinance (Chapter 155 of the Laws of Hong Kong), not subject to the supervision of the Hong Kong Monetary Authority, and not authorized to carry on banking/deposit-taking business in Hong Kong. Sample 样版 Please use this form if you want the Hong Kong Offer Shares to be issued in your name (if the application is made for your own benefi t) warrant that no other application has been or will be made for your benefi t on a WHITEor YELLOWApplication Form or by giving electronic application instructions to HKSCC or to the White Form eIPO Service Provider by you or by any one as your agent or by any other person; and (if you are making the application as an agent for the benefit of another person) warrant that (i) no other application has been or will be made by you as agent for or for the benefi t of that person or by that person or by any other person as agent for that person on a WHITEor YELLOWApplication Form or by giving electronic application instructions to HKSCC and (ii) you have due authority to sign the Application Form or give electronic application instructions on behalf of that other person as their agent. D. Power of attorney If your application is made through an authorised attorney, the Bank, the Sole Sponsor and the Sole Representative may accept or reject your application at their discretion, and on any conditions they think fit, including evidence of the attorney’s authority. Determination of Offer Price and Allocation of Hong Kong Offer Shares The Offer Price is expected to be fi xed on or around Thursday, January 5, 2017. Applicants are required to pay the maximum Offer Price of HK$4.76 for each Hong Kong Offer Share together with 1% brokerage, 0.0027% SFC transaction levy and 0.005% Hong Kong Stock Exchange trading fee. If the Offer Price is not agreed between the Bank (for itself and on behalf of the Selling Shareholders) and the Sole Representative (for itself and on behalf of the Joint Bookrunners and the Underwriters) on or before Wednesday, January 11, 2017, the Global Offering will not proceed. Applications for Hong Kong Offer Shares will not be processed and no allotment of any Hong Kong Offer Shares will be made until the application lists close. The Bank expects to announce the fi nal offer price, the indication of the level of interest in the International Offering, the level of applications under the Hong Kong Public Offering and the basis of allocation of the Hong Kong Public Offering on Wednesday, January 11, 2017 in the South China Morning Post (in English) and the Hong Kong Economic Times (in Chinese), and on the website of the Hong Kong Stock Exchange at www.hkexnews.hkand the Bank’s website at www.jtnsh.com. Results of allocations in Hong Kong Public Offering, and the Hong Kong Identity Card/passport/Hong Kong business registration numbers of successful applicants (where applicable) will be available on the above websites. If your application for Hong Kong Offer Shares is successful (in whole or in part) If you apply for 1,000,000 or more Hong Kong Offer Shares and have provided all information, you may collect your refund cheque(s) and/or share certifi cate(s) in person from H Share Registrar at Shops 1712�C1716, 17th Floor, Hopewell Centre, 183 Queen’s Road East, Wan Chai, Hong Kong from 9:00 a.m. to 1:00 p.m. on Wednesday, January 11, 2017 or such other date as notifi ed by the Bank in the newspapers. If you are an individual who is eligible for personal collection, you must not authorise any other person to collect for you. If you are a corporate applicant which is eligible for personal collection, your authorised representative must bear a letter of authorisation from your corporation stamped with your corporation’s chop. Both individuals and authorised representatives must produce, at the time of collection, evidence of identity acceptable to Computershare Hong Kong Investor Services Limited. If you do not collect your refund cheque(s) and/or share certificate(s) personally within the time period specified for collection, they will be dispatched promptly to the address as specifi ed on this Application Form by ordinary post at your own risk. If you apply for less than 1,000,000 Hong Kong Offer Shares, your refund cheque(s) and/or share certifi cate(s) will be sent to the address on the relevant Application Form on or before Wednesday, January 11, 2017, by ordinary post and at your own risk. Refund of your money If you do not receive any Hong Kong Offer Shares or if your application is accepted only in part, the Bank will refund to you your application monies (including the related 1% brokerage, 0.0027% SFC transaction levy and 0.005% Hong Kong Stock Exchange trading fee) without interest. If the offer price is less than the maximum Offer Price, the Bank will refund to you the surplus application monies (including the related 1% brokerage, 0.0027% SFC transaction levy and 0.005% Hong Kong Stock Exchange trading fee) without interest. The refund procedures are stated in the “Dispatch/Collection of share certificates and refund monies” in the “How to Apply for Hong Kong Offer Shares” section of the Prospectus. Application by HKSCC Nominees Limited (“HKSCC Nominees”) Where this Application Form is signed by HKSCC Nominees on behalf of persons who have given electronic application instructions to apply for the Hong Kong Offer Shares, the provisions of this Application Form which are inconsistent with those set out in the Prospectus shall not apply and provisions in the Prospectus shall prevail. Without limiting the generality of this paragraph, the following sections of this Application Form are inapplicable where this form is signed by HKSCC Nominees: “Applicants’ declaration” on the first page; “Warning” on the first page “If you are a nominee”; All representations and warranties under the “Effect of completing and submitting this Application Form” section, except the fi rst one regarding registration of Hong Kong Offer Shares in the applicant’s name and the signing of documents to enable the applicant to be registered as the holder of the Hong Kong Offer Shares; “If your application for Hong Kong Offer Shares is successful (in whole or in part)”; and “Refund of your money”. The following sections in the “How to Apply for Hong Kong Offer Shares” section of the Prospectus are inapplicable where this form is signed by HKSCC Nominees “How many applications can you make”; and “Circumstances in which you will not be allotted Hong Kong Offer Shares”. Sample 样版 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 JILIN JIUTAI RURAL COMMERCIAL BANK CORPORATION LIMITED * 吉林九台农村商业银行股份有限公司* （於中华人民共和国注册成立的股份有限公司） 全球发售 申请条件 甲、 可提出申请的人士 1. 阁下或　阁下为其利益提出申请的人士必须 年满18岁并有香港地址。 2. 阁下必须身处美国境外，并非美籍人士（定 义见美国证券法S规例）或属S规例第902条(h) (3)段所述的人士，亦非中国法人或自然人。 3. 如　阁下为公司，申请须以个别成员名义提 出。 4. 如　阁下为法人团体，申请须经获正式授权 人员签署，并注明其所属代表身份及盖上公 司印监。 5. 联名申请人不得超过四名。 6. 除香港上市规则或香港联交所已授予的任何 相关豁免批准外，下列人士概不得申请认购 任何香港发售股份： 本行及�u或本行任何子公司股份的现有 实益拥有人； 本行及�u或本行任何子公司的董事或行 政总裁； 本行的关连人士（定义见香港上市规则） 或紧随全球发售完成後成为本行关连人 士的人士； 上述任何人士的联系人（定义见香港上 市规则）；及 已获分配或已申请认购任何国际发售股 份或以其他方式参与国际发售的人士。 乙、 如　阁下为代名人 阁下作为代名人可提交超过一份香港发售股份 申请，方法是：(i)透过中央结算及交收系统（「中 央结算系统」）向香港结算发出电子认购指示 （如　阁下为中央结算系统参与者）；或(ii)使用 白色或黄色申请表格，以自身名义代表不同的 实益拥有人提交超过一份申请。 丙、 填交本申请表格的效用 阁下填妥并递交本申请表格，即表示　阁下（如 属联名申请人，即各人共同及个别）代表　阁下 本身，或作为　阁下代其行事的每位人士的代 理或代名人： 承诺签立所有相关文件，并指示及授权本行 及�u或作为本行代理的独家代表（或其代理 或代名人），代表　阁下签立任何文件及办 理一切必要手续，并为按照本行的公司章程 的规定将　阁下获分配的任何香港发售股份 以　阁下的名义登记； 同意遵守公司条例、公司（清盘及杂项条文） 条例及本行的公司章程； 确认　阁下已细阅招股书及本申请表格所 载的条款及条件和申请程序，并同意受其约 束； 确认　阁下已接获及细阅招股书，提出申请 时也仅依据招股书载列的资料及陈述，而除 招股书任何补充文件外，不会依赖任何其他 资料或陈述； 确认　阁下知悉招股书内有关全球发售的限 制； 同意本行、售股股东、独家代表、联席全球 协调人、独家保荐人、联席账簿管理人、联 席牵头经办人、承销商、彼等各自的董事、 高级职员、雇员、合夥人、代理、顾问及参 与全球发售的任何其他各方现时及日後均毋 须对并非招股书（及其任何补充文件）所载的 任何资料及陈述负责； 承诺及确认　阁下或　阁下为其利益提出申 请的人士并无且亦不会申请或接纳或表示有 意认购国际发售的任何发售股份，也没有参 与国际发售； 同意在本行、H股证券登记处、收款银行、 独家保荐人、独家代表、联席全球协调人、 联席账簿管理人、联席牵头经办人、承销商 及�u或彼等各自的顾问及代理提出要求时， 向彼等披露其所要求提供有关　阁下及　阁 下为其利益提出申请的人士的个人资料； 若香港境外任何地方的法例适用於　阁下 的申请，则同意及保证　阁下已遵守所有有 关法例，且本行、售股股东、独家保荐人、 独家代表、联席全球协调人、联席账簿管理 人、联席牵头经办人及承销商和彼等各自的 高级职员或顾问概不会因接纳　阁下的购买 要约，或　阁下在招股书及本申请表格所载 的条款及条件项下的权利及责任所引致的任 何行动，而违反香港境外的任何法例； 同意　阁下的申请一经接纳，即不得因无意 的失实陈述而撤销； 同意　阁下的申请受香港法例规管； 声明、保证及承诺：(i)阁下明白香港发售股 份不曾亦不会根据美国证券法登记；及(ii)阁 下及　阁下为其利益申请香港发售股份的人 士均身处美国境外（定义见S规例），或属S规 例第902条第(h)(3)段所述的人士； 保证　阁下提供的资料真实及准确； 同意接纳所申请数目或根据申请分配予　阁 下但数目较少的香港发售股份； 授权本行将　阁下的姓名�u名称或香港结算 代理人的名称列入本行股东名册，作为　阁 下获分配的任何香港发售股份的持有人，并 授权本行及�u或其代理以普通邮递方式按申 请所示地址向　阁下或联名申请的排名首位 申请人发送任何股票及�u或任何电子退款 * 吉林九台农村商业银行股份有限公司并非香港法例第155章银行业条例所指的认可机构，不受限於香港金融管理局的监督、亦 不获授权在香港经营银行�u接受存款业务。 Sample 样版 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 指示及�u或退款支票，邮误风险由　阁下承 担，除非　阁下已符合招股书「亲身领取」一 节的条件亲身领取股票及�u或退款支票； 声明及表示此乃　阁下为本身或为其利益提 出申请的人士提出及拟提出的唯一申请； 明白本行及独家代表将依据　阁下的声明及 陈述而决定是否向　阁下分配任何香港发售 股份，　阁下如作出虚假声明，可能会被检 控； （如本申请为　阁下本身的利益提出）保 证　阁下或作为　阁下代理的任何人士或任 何其他人士不曾亦不会为　阁下的利益以白 色或黄色申请表格或向香港结算或白表eIPO 服务供应商发出电子认购指示而提出其他申 请；及 （如　阁下作为代理为另一人士的利益提出 申请）保证(i)　阁下（作为代理或为该人士利 益）或该人士或任何其他作为该人士代理的 人士不曾亦不会以白色或黄色申请表格或向 香港结算发出电子认购指示而提出其他申 请；及(ii)　阁下获正式授权作为该人士的 代理代为签署本申请表格或发出电子认购指 示。 丁、 授权书 如　阁下透过授权人士提出申请，本行、独家保 荐人及独家代表可按其认为合适的条件（包括出 示获授权证明）酌情接纳或拒绝　阁下的申请。 厘定发售价及香港发售股份的分配 预期发售价於2017年1月5日（星期四）或前後厘 定。申请人须缴付每股香港发售股份4.76港元的 最高发售价，另加1%经纪佣金、0.0027%证监会 交易徵费及0.005%香港联交所交易费。倘若本 行（代表其自身和售股股东）与独家代表（代表其 自身和联席账簿管理人及承销商）并无於2017年 1月11日（星期三）或之前协定发售价，全球发售 将不会进行。 截止登记认购申请前，概不处理香港发售股份 的申请或配发任何香港发售股份。 本行预期於2017年1月11日（星期三）在南华早报 （英文）、香港经济日报（中文）、香港联交所网 站www.hkexnews.hk及本行网站www.jtnsh.com公 布最终发售价、国际发售踊跃程度、香港公开 发售认购水平及香港公开发售分配基准。香港 公开发售的分配结果以及成功申请人的香港身 份证�u护照�u香港商业登记号码（如适用）亦同 於上述网站公布。 如　阁下成功申请认购香港发售股份（全部或部 分） 如　阁下申请认购1,000,000股或以上香港发售股 份，且已提供申请表格所规定的全部资料，　阁 下可於2017年1月11日（星期三）或本行在报章上 公布的其他日期上午九时正至下午一时正，亲 身前往香港湾仔皇后大道东183号合和中心17楼 1712�C1716室，H股证券登记处领取退款支票及�u 或股票。 如　阁下为个人申请人并合资格亲身领取，　阁 下不得授权任何其他人士代领。如　阁下为公 司申请人并合资格亲身领取，　阁下的授权代 表须携同盖上公司印监的授权书领取。个人申 请人及授权代表领取股票时均须出示香港中央 证券登记有限公司接纳的身份证明文件。 如　阁下并无在指定领取时间内亲身领取退款 支票及�u或股票，有关支票及�u或股票将会立 刻寄往本申请表格所示地址，邮误风险由　阁 下承担。 如　阁下申请认购1,000,000股以下香港发售股 份，　阁下的退款支票及�u或股票将於2017年1 月11日（星期三）或以前以普通邮递方式寄往本 申请表格所示地址，邮误风险由　阁下承担。 退回款项 若　阁下未获分配任何香港发售股份或申请仅 部分获接纳，本行将不计利息退回　阁下的申请 股款（包括相关的1%经纪佣金、0.0027%证监会 交易徵费及0.005%香港联交所交易费）。如最终 厘定的发售价低於最高发售价，本行将不计利 息退回多收申请股款（包括相关的1%经纪佣金、 0.0027%证监会交易徵费及0.005%香港联交所交 易费）。 有关退款程序载於招股书「如何申请香港发售股 份」一节「发送�u领取股票及退回股款」一段。 香港中央结算（代理人）有限公司（「香港结算代 理人」）提出的申请 如本申请表格由香港结算代理人代表发出电子 认购指示申请香港发售股份的人士签署，本申 请表格与招股书不符的条文将不适用，且以招 股书所述者为准。 在不限制此段一般应用的前提下，本申请表格 的以下部分在香港结算代理人作签署人的情况 下并不适用： 第一页的「申请人声明」； 第一页的「警告」； 「如　阁下为代名人」； 「填交本申请表格的效用」一节项下的所有陈 述及保证，惟首项有关以申请人名义登记香 港发售股份及签署使申请人登记成为香港发 售股份持有人的文件除外； 「如　阁下成功申请认购香港发售股份（全部 或部分）」；及 「退回款项」。 招股书「如何申请香港发售股份」一节的以下部 分在香港结算代理人作签署人的情况下并不适 用： 「　阁下可提交的申请数目」；及 「　阁下不获配发香港发售股份的情况」。 Sample 样版 Please use this form if you want the Hong Kong Offer Shares to be issued in your name Personal Data Personal Information Collection Statement This Personal Information Collection Statement informs the applicant for, and holder of, Hong Kong Offer Shares, of the policies and practices of the Bank and its H Share Registrar in relation to personal data and the Personal Data (Privacy) Ordinance (Chapter 486 of the Laws of Hong Kong) (the “Ordinance”). 1. Reasons for the collection of your personal data It is necessary for applicants and registered holders of securities to supply correct personal data to the Bank or its agents and the H Share Registrar when applying for securities or transferring securities into or out of their names or in procuring the services of the H Share Registrar. Failure to supply the requested data may result in your application for securities being rejected, or in delay or the inability of the Bank or its H Share Registrar to effect transfers or otherwise render their services. It may also prevent or delay registration or transfers of the Hong Kong Offer Shares which you have successfully applied for and/ or the dispatch of share certifi cate(s) and/or refund cheque(s) to which you are entitled. It is important that securities holders inform the Bank and the H Share Registrar immediately of any inaccuracies in the personal data supplied. 2. Purposes The personal data of the securities holders may be used, held, processed, and/or stored (by whatever means) for the following purposes: processing your application and refund cheque, where applicable, verifi cation of compliance with the terms and application procedures set out in this Application Form and the Prospectus and announcing results of allocation of the Hong Kong Offer Shares; compliance with applicable laws and regulations in Hong Kong and elsewhere; registering new issues or transfers into or out of the names of securities’ holders including, where applicable, HKSCC Nominees; maintaining or updating the register of securities’ holders of the Bank; verifying securities holders’ identities; establishing benefit entitlements of securities’ holders of the Bank, such as dividends, rights issues, bonus issues, etc.; distributing communications from the Bank and its subsidiaries; compiling statistical information and securities’ holder profiles; disclosing relevant information to facilitate claims on entitlements; and any other incidental or associated purposes relating to the above and/or to enable the Bank and the H Share Registrar to discharge their obligations to securities’ holders and/or regulators and/or any other purposes to which the securities’ holders may from time to time agree. 3. Transfer of personal data Personal data held by the Bank and the H Share Registrar relating to the securities holders will be kept confidential but the Bank and its H Share Registrar may, to the extent necessary for achieving any of the above purposes, disclose, obtain or transfer (whether within or outside Hong Kong) the personal data to, from or with any of the following: the Bank’s appointed agents such as financial advisers, receiving bankers and overseas principal share registrar; where applicants for securities request a deposit into CCASS, HKSCC or HKSCC Nominees, who will use the personal data for the purposes of operating CCASS; any agents, contractors or third-party service providers who offer administrative, telecommunications, computer, payment or other services to the Bank or the H Share Registrar in connection with their respective business operation; the Hong Kong Stock Exchange, the SFC and any other statutory regulatory or governmental bodies or otherwise as required by laws, rules or regulations; and any persons or institutions with which the securities’ holders have or propose to have dealings, such as their bankers, solicitors, accountants or stockbrokers etc. 4. Retention of personal data The Bank and its H Share Registrar will keep the personal data of the applicants and holders of securities for as long as necessary to fulfi l the purposes for which the personal data were collected. Personal data which is no longer required will be destroyed or dealt with in accordance with the Ordinance. 5. Access to and correction of personal data Securities holders have the right to ascertain whether the Bank or the H Share Registrar hold their personal data, to obtain a copy of that data, and to correct any data that is inaccurate. The Bank and the H Share Registrar have the right to charge a reasonable fee for the processing of such requests. All requests for access to data or correction of data should be addressed to the Bank, at its registered address disclosed in the “Corporate Information” section of the Prospectus or as notifi ed from time to time, for the attention of the Bank secretary, or the H Share Registrar for the attention of the privacy compliance officer. By signing an Application Form or by giving electronic application instructions to HKSCC, you agree to all of the above. Sample 样版 如　阁下欲以本身名义登记将获发行的香港发售股份，请使用本表格 个人资料 个人资料收集声明 此项个人资料收集声明是向香港发售股份的申 请人和持有人说明有关本行及其H股证券登记处 有关个人资料和香港法例第486章个人资料（私 隐）条例（「条例」）方面的政策和惯例。 1. 收集　阁下个人资料的原因 证券申请人及登记持有人以本身名义申请证券 或转让或受让证券时或寻求H股证券登记处的服 务时，必须向本行或其代理人及H股证券登记处 提供准确个人资料。 未能提供所要求的资料可能导致　阁下申请证 券被拒或延迟，或本行或其H股证券登记处无 法落实转让或提供服务。此举也可能妨碍或延 迟登记或转让　阁下成功申请的香港发售股份 及�u或寄发　阁下应得的股票及�u或退款支票。 证券持有人所提供的个人资料如有任何错误， 须立即通知本行及H股证券登记处。 2. 用途 证券持有人的个人资料可被采用及以任何方式 持有、处理及�u或保存，以作下列用途： 处理　阁下的申请及退款支票（如适用）、 核实是否符合本申请表格及招股书载列的 条款和申请程序以及公布香港发售股份的 分配结果； 遵守香港及其他地区的适用法律及法规； 以证券持有人（包括香港结算代理人（如适 用））的名义登记新发行证券或转让或受让 证券； 存置或更新本行证券持有人的名册； 核实证券持有人的身份； 确定本行证券持有人的受益权利，例如股 息、供股和红股等； 分发本行及其附属公司的通讯； 编制统计数据和证券持有人资料； 披露有关资料以便就权益索偿；及 与上述有关的任何其他附带或相关目的及�u 或使本行及H股证券登记处能履行对证券持 有人及�u或监管机构承担的责任及�u或证 券持有人不时同意的任何其他目的。 3. 转交个人资料 本行及H股证券登记处所持有关证券持有人的个 人资料将会保密，但本行及其H股证券登记处可 以在为达到上述任何目的之必要情况下，向下 列任何人士披露、获取或转交（无论在香港境内 或境外）有关个人资料： 本行委任的代理人，例如财务顾问、收款银 行和主要海外股份过户登记处； （如证券申请人要求将证券存於中央结算系 统）香港结算或香港结算代理人；彼等将会 就中央结算系统的运作使用有关个人资料； 向本行或H股证券登记处提供与其各自业务 营运有关的行政、电讯、电脑、付款或其他 服务的任何代理人、承包商或第三方服务 供应商； 香港联交所、证监会及任何其他法定监管 机关或政府部门或遵照其他法例、规则或 法规；及 证券持有人与其进行或拟进行交易的任何 人士或机构，例如彼等的银行、律师、会计 师或股票经纪等。 4. 个人资料的保留 本行及其H股证券登记处将按收集个人资料所需 的用途保留证券申请人及持有人的个人资料。 无需保留的个人资料将会根据条例销毁或处理。 5. 查阅和更正个人资料 证券持有人有权确定本行或H股证券登记处是否 持有其个人资料，并有权索取有关该资料的副 本并更正任何不准确资料。本行和H股证券登记 处有权就处理任何查阅资料的要求收取合理费 用。 所有查阅资料或更正资料的要求应按招股书「公 司资料」一节所披露或不时通知的本行注册地址 送交本行的公司秘书，或向H股证券登记处的个 人资料私隐事务主任提出。 阁下签署申请表格或向香港结算发出电子认购 指示，即表示同意上述各项。 Sample 样版