To exer­cise options in Athena, please pro­ceed as follows:

• Fill out the form below
• Con­fir­ma­tion page will dis­play a link to a print­able PDF.
• Print the PDF, sign and return via fax to Athena on (08) 9428 2910 or email to ahn@athenaresources.com.au
• Remit pay­ment accord­ing to the instruc­tions on the con­fir­ma­tion page.
• Please use your SRN/HIN Num­ber as your Funds Trans­fer Ref­er­ence or if pay­ing by Cheque please write the SRN/HIN on the reverse.

• Title: Mr Ms Mrs
• First Name:*
• Last Name:*
• Address Line 1:*
• Address Line 2:
• Town/Suburb:*
• County/State:*
• Postcode:*
• Country:*
• Number of Options to be Exercised:*
• SRN/HIN:*

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