Proxy Solicitation & Information Statement • Jan 20, 2017
Proxy Solicitation & Information Statement
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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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