Cap Table

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

CAPITALIZATION TABLE

As of: {{date}}

Company Registration Number: {{company_registration_number}}

This Capitalization Table (the “Cap Table”) sets forth the equity ownership of {{company_name}} (the “Company”) as at the date indicated above, on a fully diluted basis. All share figures are reflected post-consolidation/split if applicable.

SHAREHOLDER SUMMARY

| Shareholder Name | Shares Held | Percentage Ownership (%) | Date Acquired | Share Certificate No. |

|---|---|---|---|---|

| {{shareholder_name_1}} | {{shares_held_1}} | {{percentage_ownership_1}} | {{date_acquired_1}} | {{share_certificate_number_1}} |

| {{shareholder_name_2}} | {{shares_held_2}} | {{percentage_ownership_2}} | {{date_acquired_2}} | {{share_certificate_number_2}} |

| [Add more rows as needed] | | | | |

Total Issued Shares: {{total_issued_shares}}

EQUITY INSTRUMENTS

This section details all equity instruments that may impact dilution or ownership.

**Ordinary Shares**:

- Total Authorized Ordinary Shares: {{total_authorized_ordinary_shares}}

- Par Value per Ordinary Share: {{par_value_ordinary_share}}

**Preference Shares** (if any):

| Class of Preference Share | Number of Shares | Conversion Ratio (if applicable) | Liquidation Preference | Investor |

|---|---|---|---|---|

| {{preference_share_class_1}} | {{number_preference_shares_1}} | {{conversion_ratio_1}} | {{liquidation_preference_1}} | {{preference_share_investor_1}} |

| [Add more rows as needed] | | | | |

OPTION POOL / EMPLOYEE SHARE OWNERSHIP PLAN (ESOP)

This section details any employee stock option plans or similar incentive schemes.

- Total Shares Reserved for Option Pool/ESOP: {{shares_reserved_option_pool}}

- Shares Granted: {{shares_granted_option_pool}}

- Shares Available for Grant: {{shares_available_for_grant}}

CONVERTIBLE INSTRUMENTS

This section details any outstanding convertible notes, SAFEs (Simple Agreements for Future Equity), or other instruments that could convert into equity.

| Instrument Type | Holder | Principal Amount / Valuation Cap | Conversion Terms | Date Issued |

|---|---|---|---|---|

| {{instrument_type_1}} | {{holder_1}} | {{principal_amount_1}} | {{conversion_terms_1}} | {{date_issued_1}} |

| [Add more rows as needed] | | | | |

FULLY DILUTED CAPITALIZATION

The fully diluted outstanding shares include all issued shares, shares reserved for conversion of convertible instruments, and shares under option/warrants.

**Calculation:**

1. Total Issued Ordinary Shares: {{total_issued_ordinary_shares_current}}

2. Assumed Conversion of Preference Shares: {{assumed_conversion_preference_shares}}

3. Assumed Conversion of Convertible Notes/SAFEs: {{assumed_conversion_convertible_instruments}}

4. Shares from Exercised Options/Warrants: {{shares_from_exercised_options}}

**Total Fully Diluted Shares:** {{total_fully_diluted_shares}}

PERCENTAGE OWNERSHIP (FULLY DILUTED)

| Shareholder Name | Shares Held (Fully Diluted) | Percentage Ownership (Fully Diluted) (%) |

|---|---|---|

| {{shareholder_name_fd_1}} | {{shares_held_fd_1}} | {{percentage_ownership_fd_1}} |

| {{shareholder_name_fd_2}} | {{shares_held_fd_2}} | {{percentage_ownership_fd_2}} |

| [Add more rows as needed] | | |

NOTES AND ASSUMPTIONS

1. This Cap Table is based on information available as of the date specified at the beginning of the document.

2. All conversions of convertible instruments are assumed at their most dilutive scenario, unless otherwise stated.

3. This document does not constitute legal or financial advice and should be reviewed by legal and financial professionals.

4. Any changes to the share capital structure must be formally documented and approved according to the company’s constitutive documents (e.g., Memorandum of Incorporation/Articles of Association).

Signature Block

_____________________________

Name: {{authorized_signatory_name}}

Title: {{authorized_signatory_title}}

For and on behalf of {{company_name}}

Date: {{signature_date}}