3 , rue d' Antin, 75002 Paris- Immatriculée sous le n° 552 108 011 RCS Paris -Identifiant C E FR60552108011 FR- Page 1 sur 1 Version 2015. 05 STOCK MARKET ORDER FORM PURCHASE I the undersigned... Name of the Stock (mandatory) 2 ISIN Code Number of shares (in words() in figures) Type of order 1 At market price Limit order at EUR (show the maximum purchase price.