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EBR SYSTEMS INC. Regulatory Filings 2021

Nov 22, 2021

64814_rns_2021-11-22_793d7ee8-402d-4bf0-b602-1eca5dcf64b0.pdf

Regulatory Filings

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Rule 1.7

Appendix 1A

Application for Admission to the ASX Official List (ASX Listing)

Name of entity[1]

Name of entity1
EBR Systems, Inc.
ABN/ARBN654 147 127 Date of this form
654 147 127 15 October 2021

We (the entity named above) apply for admission to the[+] official list of ASX Limited (ASX) as an ASX Listing and for[+] quotation of the following[+] securities (or such other number of[+] securities as we may notify to ASX prior to the commencement of[+] quotation):

Number +Class (quoted only)
Estimated maximum numberand+class of+securities to bequoted on ASX at thecommencement of quotation onASX 256,998,494 CHESS Depositary Interests

By giving this form to ASX, we agree to the matters set out in Appendix 1A of the ASX Listing Rules.

Notes:

1. If the entity seeking admission is a trust, the application should be in the form “[Name of responsible entity of trust] in its capacity as responsible entity of [Name of trust]”.

2. An entity seeking admission to the official list as an ASX Listing must also provide to ASX the information and documents referred to in the Information Form and Checklist (ASX Listing) published on the ASX website.

ASX Listing Rules Appendix 1A (01/12/19) + See chapter 19 of the ASX Listing Rules for defined terms.

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