Amber Grid — Proxy Solicitation & Information Statement 2019

Mar 28, 2019

Translation from the Lithuanian

Annex 4

AB Amber Grid

GENERAL BALLOT PAPER

GENERAL MEETING OF SHAREHOLDERS OF 23 APRIL 2019

INFORMATION ABOUT SHAREHOLDER

Name of the shareholder:

Code of the shareholder:

Number of shares:

VOTING

Please circle the voting option elected: "FOR" or "AGAINST"

No	Issue on the agenda	Draft resolution proposed	Expression of shareholder's volition
1.	Annual Report of AB Amber Grid for 2018.	Decision of the Annual General Meeting of Shareholders is not required. The Board submits Annual Report of the Company for 2018 to take account of (added).
2.	Auditor's report on AB Amber Grid financial statements for 2018 and AB Amber Grid Annual Report 2018.	Decision of the Annual General Meeting of Shareholders is not required. When taking decisions regarding approval of AB Amber Grid financial statements for 2018, to take note of the opinion presented in the Independent auditor's report to the shareholders of AB Amber Grid (added).
3.	Approval of AB Amber Grid financial statements for 2018.	To approve AB Amber Grid financial statements for 2018 (added).	“FOR”	“AGAINST”

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4.	Approval of AB Amber Grid Profit (Loss) Allocation for 2018.	To approve of AB Amber Grid Profit (Loss) Allocation for 2018 (added).	“FOR”	“AGAINST”
5.	Amendment of remuneration of Independent Board members of AB Amber Grid	From 1 April 2019 to set an hourly fee of 60 (sixty) euros (before tax) for an Independent board member of the company's board, up to a maximum amount of 1,200 (one thousand two hundred) euros per month (before tax). In case that an Independent board member would be elected the Chairman of the Board, set a maximum amount of 1.560 (one thousand five hundred sixty) euros per month (before tax).	“FOR”	“AGAINST”
			“FOR”	“AGAINST”
6.	Approval of standard contract terms (standard contract forms) of AB Amber Grid Board members (without remuneration; with remuneration)	To approve the terms and conditions of the standard contracts of the members of the Board (standard forms of contracts) (without remuneration; with remuneration) (attached).	“FOR”	“AGAINST”

Note:
1. 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)