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Gentian Diagnostics ASA

Proxy Solicitation & Information Statement Jan 20, 2017

3604_iss_2017-01-20_846e0b51-91da-4b70-81b0-1443e49c6056.pdf

Proxy Solicitation & Information Statement

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Appendix 3

PROXY – Extraordinary general meeting of Gentian Diagnostics AS

If you are unable to attend the extraordinary general meeting on 30 January 2017, you can authorize someone to meet and vote on your behalf by sending this proxy authorisation to Gentian Diagnostics AS, PO Box 733, NO -1509 Moss, or by e-mail: [email protected]

The undersigned shareholder of Gentian Diagnostics AS hereby authorises:

□ Chairman of the board of directors John Afseth or the one he designates

____________________________________ Name of proxy-holder

to attend and vote on my behalf at the extraordinary general meeting 30 January 2017. If this proxy authorisation is submitted without naming the proxy-holder, the proxy shall be deemed given to the chairman of the board of directors or the one he designates.

The voting shall be conducted in accordance with the instructions below. If the boxes are not ticked, this will be interpreted as an instruction to vote in "favour" of the proposal in the notice. In the event of proposals that replace or supplement the proposals in the notice, the proxy-holder will decide how to vote.

Item: For Against Abstain Proxy
holder
determines
2. Approval of the notice and the agenda
4. Private placement
5. Board authorization share capital increase
6. Board election and remuneration
Shareholder's name and address: _______
(please use capital letters)
___
______
_________

date place shareholder's signature

If the shareholder is a company, a certificate of registration must be enclosed with the proxy.

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