Proxy Solicitation & Information Statement • Apr 18, 2019
Proxy Solicitation & Information Statement
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The undersigned:
| Legal person: | ||
|---|---|---|
| Name and legal form: | ||
| Registered office: | ||
| Company number: | ||
| Lawful representative: | ||
| Mr/Mrs | position: | and |
| Mr/Mrs | position: | |
| owner of | share(s) in the NATIONAL BANK OF BELGIUM, hereby give power of attorney to: | |
| Mr/Mrs | position |
Surname and first name:
Address:
owner of share(s) in the NATIONAL BANK OF BELGIUM, hereby give power of attorney to: Surname and first name:
Address:
Pursuant to Article 547bis, §4 of the Company Code, in the event of any potential conflict of interests between a shareholder and his appointed representative, the representative is not authorised to exercise the voting right on behalf of the shareholder unless he has specific voting instructions for each item on the agenda. Without that, proxies will not be valid.
Conflicts of interest exist in particular if the representative:
1° is the Bank, is a shareholder who controls the Bank or is another entity controlled by such a shareholder;
2° is a member of the Bank's Board of Directors, or a member of the management bodies of a shareholder who controls the Bank or a controlled entity referred to in 1°;
3° is an employee or external auditor of the Bank or of the Bank's controlling shareholder or of a controlled entity referred to in 1°;
4° is related to a natural person referred to in 1° to 3° or is the spouse or legal partner of such a person, or of a relation of such a person.
Proxies returned to the Bank without indicating a representative will be deemed to be addressed to the chairman of the Board of Directors and consequently fall within the scope of potential conflicts of interest. They will not be valid unless voting instructions are indicated for each item on the agenda.
to
Proposal for decision: renewal of the term of office of the censors Mia De Schamphelaere, Herman Matthijs and Dimitri Lhoste
(tick the appropriate box if you are in the situation of a potential conflict of interests - see box above)
Renewal of the term of office of Mrs Mia De Schamphelaere For Against Abstention Renewal of the term of office of Mr Herman Matthijs For Against Abstention Renewal of the term of office of Mr Dimitri Lhoste For Against Abstention
In the case of extra items added to the agenda and proposals for decisions relating to them in accordance with Article 533ter of the Companies Code after notification of this proxy, the representative:
(tick the appropriate box)
is authorised to vote on the new items entered on the agenda
must abstain
Done at (date)
THE SHAREHOLDER (Signature) (1)
(1) If the form is completed electronically, it must bear an electronic signature conforming to the legal requirements concerning electronic signatures.
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