有價證券買入委託書

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│證券種類│                                                          │
├────┼─────────────────────────────┤
│數    量│                                                          │
├────┼─────────────────────────────┤
│指定價格│                                                          │
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│預存金額│                                                          │
├────┼─────────────────────────────┤
│現 定 期│                                                          │
├────┼─────────────────────────────┤
│限    期│                                                          │
├────┼─────────────────────────────┤
│備    考│                                                          │
└────┴─────────────────────────────┘
上列證券委託貴公司買入，請即依照貴公司代買證券規則辦理。　此致　上海信託股份有限公司
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