Anheuser-Busch InBev SA/NV — AGM Information 2012

Mar 23, 2012

CONFIRMATION OF PARTICIPATION

Shareholders' meeting of Anheuser-Busch InBev SA/NV (the "Company") of April 25, 2012 (11.00 am)

This signed original paper form must be returned by mail by Thursday April 19, 2012 17.00 pm CET at the latest to:

Anheuser-Busch InBev SA/NV Mr. Benoît Loore Brouwerijplein 1 3000 Leuven (Belgium)

The undersigned (name and first name / name of the company) ……………………………………………………………………………………………………………
Domicile / Registered office		……………………………………………………………………………………………………………
		……………………………………………………………………………………………………………
Owner of		dematerialized shares () registered shares ()	of Anheuser-Busch InBev SA/NV
	quantity
		Brussels on Wednesday April 25, 2012 (11.00 am) with all above-mentioned shares.	Confirms his intention to participate in the shareholders' meeting of the Company that will be held in

Done at …………………………………………., on …………………….

Signature(s) : ……………………………………….(**)