Proxy Solicitation & Information Statement • May 13, 2025
Proxy Solicitation & Information Statement
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Place and date of issuance of the power of attorney
_____________________________
If an individual - name, surname, personal code (if the person does not have a personal code, date of birth, identification document number and date of issue, country, and issuing authority); if a legal entity - name, registration number, legal address, representative, basis of representation
_________________________________________________________________________
_________________________________________________________________________
as the grantor of the power of attorney (hereinafter – the Grantor) hereby authorizes
If an individual - name, surname, personal code (if the person does not have a personal code, date of birth, identification document number and date of issue, country, and issuing authority) or legal entity - name, registration number, legal address, representative, basis of representation
as the attorney (hereinafter – the Attorney) to represent the interests of the Grantor at the shareholders' meeting of AS "Latvijas Jūras medicīnas centrs" (registration number: 40003306807, legal address: Rīga, Patversmes iela 23, LV-1005)
year, month, and date of the shareholders' meeting
with _____________________________________ shares (votes) owned by the Grantor. (all or specifying the number of shares)
_______________________________________ Grantor's Signature*
*If the Grantor is an individual, the signature and the name in print must be provided. If the Grantor is a legal entity, the representative's position, signature, name in print, and seal impression (if available) must be provided.
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