Delfin Group

AGM Information • Feb 25, 2022

---

author: "Just\u012bne Ignatavi\u010dute I ESB"
date: 2022-02-22 15:46:00+00:00
processor: python-docx+mammoth
status: success

---

Application form for the participation at the Extraordinary Meeting of Shareholders to be held on 28 March 2022 at 15:00 of AS “DelfinGroup”

Registration number: 40103252854

Legal address: Skanstes iela 50A, Riga, LV-1013, Latvia

Name, last name or company name of the shareholder
Shareholder’s personal identity code (if the person does not have a personal identification number - the date of birth, the number, the date of issue, the country of issuance and the issuing authority of the passport or other identification document) or registration number
Number of shares owned (represented)
Name, last name of the proxy or representative of the shareholder (if applicable)
Registration number or personal identity number of the proxy or representative of the shareholder (if applicable) (If the person does not have a personal identification number - the date of birth, the number, the date of issue, the country of issuance and the issuing authority of the passport or other identification document)
Method of participation (remotely / present in person)
Phone number for contacting
E-mail for contact and receipt of the link for remote participation

I hereby certify the accuracy of the information provided here and in case of my participation remotely undertake not to transfer the provided participation link of the meeting to another person.

______________________________ / signature in case the document is signed physically in paper form

______________________________ / date in case the document is signed physically in paper form

THIS DOCUMENT HAS BEEN SIGNED WITH A SECURE ELECTRONIC SIGNATURE AND CONTAINS A TIME STAMP / in case the document is signed with safe electronic signature

* In case of a remote participation, this application has to be submitted to AS “DelfinGroup” until 22 March 2022. In case of present participation in person, this application has to be submitted to AS “DelfinGroup” until 22 March 2022.

** The processing of personal data will be performed only for the identification of a person for the purposes of the shareholders' meeting in compliance with the applicable laws and regulations in force.