Proxy Solicitation & Information Statement • Oct 11, 2019
Proxy Solicitation & Information Statement
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| Name: | |
|---|---|
| Registration number (for legal entities) or date of birth/personal ID code (for private individuals): |
|
| Address: | |
| Telephone number: | |
| E-mail: | |
| Represented by (for legal entities): |
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| Capacity (e.g., Note holder, Note holder's custodian, legal representative of Note holder, holder of nominee account, other (specify))*: |
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| Number of Notes owned: |
* Please note if the voting form has been signed by the Note holders' custodian, based on financial instruments' account agreement and Note holders consent, the voting form details (name, registration number, address, phone number, email, representative) can be filled with Custodian details.
In accordance with the application of SIA "ExpressCredit" for receipt of the Note holder's consent dated 11 October 2019 (hereinafter – Application) SIA "ExpressCredit" has asked the Note holders of the notes issued in accordance with the prospectus of SIA "ExpressCredit" dated 17 March 2014 (ISIN: LV0000801322) (hereinafter – Prospectus) to grant their consent for amendments to the Prospectus. Amendments to the Prospectus are described in the Application and attached in Schedule 1 to the Application (hereinafter – Amendments).
The Note holder hereby votes on the Amendments as follows:
Vote instructions. If you wish to vote "for" the proposed Amendments, please underline or encircle FOR. However, if you wish to vote "against" the proposed Amendments, please underline or encircle AGAINST.
Place and date: ________________________
Signature: ________________________
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