Amber Grid - Proxy Solicitation & Information Statement 2018

Annex 4

AB Amber Grid

GENERAL BALLOT PAPER

gENERAL MEETING OF SHAREHOLDERS OF 17 OCTOBER 2018

INFORMATION ABOUT SHAREHOLDER

Name of the shareholder:

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Code of the shareholder:

___________________________________________________________________________________________________________________

Number of shares:

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VOTING

Please circle the voting option elected: “FOR” or “AGAINST”


No	Issue on the agenda	Draft resolution proposed	Expression of shareholder‘s volition
1.	Election of the Audit Company and determining the terms of compensation for audit services for the year 2018.	To elect UAB Deloitte Lietuva, code 111525235, address Vilnius, Jogailos str. 4, as the Audit Company to perform the audit of AB Amber Grid financial statements of 2018 (drawn up in accordance with the International Financial Reporting Standards and of the Annual Report and regulated activity financial statements prepared in accordance with the requirements established by the Law on Natural Gas and secondary legislation) and to set remuneration for the services of the audit of the financial statements and related statements at EUR 32,700 (excluding VAT).	“FOR”	“AGAINST”
2.	Approval of 3 October 2018 decision of the Board of AB Amber Grid on approval of Installation works of the main gas pipeline pig launchers / receivers and prompt technological control equipment of gas transmission system (II stage), to be concluded between UAB Šiaulių dujotiekio statyba and AB Amber Grid.	To approve 3 October 2018 decision of the Board of AB Amber Grid on approval of Installation works of the main gas pipeline pig launchers / receivers and prompt technological control equipment of gas transmission system (II stage), to be concluded between UAB Šiaulių dujotiekio statyba and AB Amber Grid (attached).	“FOR”	“AGAINST”

Note:

As provided by the law, all draft resolution proposals, if any, received before the date of posting off of the General Ballot Paper will be included in the General Ballot Paper.

______________ ________________________________________________________________________________________

(Date) Name, surname, position, signature of a shareholder (or any other person, authorized to vote his shares)

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