Carlson Investments Se

Proxy Solicitation & Information Statement • Jun 2, 2023

POWER OF ATTORNEY

I ..................................., PESEL ........................... domiciled in ............................., hereby grant to Mr./Ms.................., who holds ą identity card series ...... no. ......, domiciled in ......................, the power of attorney to attend and exercise the voting rights of the shares in CARLSON INVESTMENTS SE held by me as a shareholder ....................... at the Annual General Meeting convened for June 28, 2023.

Within the scope of the subject matter of this power of attorney, the proxy is authorized to perform all actions related to the purpose of this power of attorney, in particular to:

1) to make proposals;

2) exercise voting rights at the discretion of the proxy;

3) raising objections.

This power of attorney is exempt from stamp duty, due to the fact that this type of power of attorney is not covered by the Act of July 16, 2006 on stamp duty (Journal of Laws 2006 No. 225, item 1635, as amended).

Caption: ...................................................................

..................................., ........................ r. [Locality].