AGM Information • Apr 27, 2012
AGM Information
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The undersigned
| First name ……………………………………………………………………………………………… | |
|---|---|
| Family name …………………………………………………………………………………………… | |
| Address ………………………………………………………………………………………………… | |
or
| Corporate name………………………………………………………………………………………… |
|---|
| Form of corporation……………………………………………………………………………………. |
| Registered office ……………………………………………………………………………………… |
| hereby represented by |
…………………………………………………………………………………………………………… (family name, first name, title of the proxy holder) whom declares and certifies to the S.A. D'Ieteren N.V. to have the necessary power of attorney to sign this form on behalf of the shareholder
holder on the registration date of 17 May 2012 of………………….…ordinary shares in registered form/held with …………………………………………………………….(name of financial institution) (*), of S.A. D'Ieteren N.V., with registered office located at 1050 Brussels, rue du Mail 50, registered with the Company Register Brussels under the number 0403448140 and with which he/she hereby declares to vote,
votes as selected below with respect to the items on the agenda of the Ordinary general meeting of the company which will take place on Thursday May 31 at 3:00 pm at the company's registered office :
| Point 1 | Point 2 |
|---|---|
| [This item does not require a vote] | vote in favour |
| vote against | |
| abstain | |
| Point 3 | Point 4.1 |
| vote in favour | vote in favour |
| vote against | vote against |
| abstain | abstain |
| Point 4.2 | |
| vote in favour | |
| vote against | |
| abstain |
(*) Please delete the unnecessary (**) Please indicate your vote by ticking the appropriate box
In the absence of clear voting instructions with respect to the proposed resolutions, this form will be considered as null and void.
This original form of this vote by correspondence, duly filled in and signed, must be addressed to Euroclear Belgium,
by post, avenue de Schiphol 6, 1140 Brussels (Belgium) or
by e-mail to the address [email protected] or
by fax to the number + 322 337 54 46
on Friday 25th May at 4:00 pm at the latest.
In addition, the owners of dematerialized shares should address to Euroclear Belgium, at the same addresses as above, a certificate set out by their agreed account holder or clearing institution, attesting the number dematerialised shares held in the shareholder's name in its books at the registration date with which he/she has here above declared to vote.
This vote by correspondence is irrevocable. It remains valid (a) for the following general meetings which would be held with the same agenda and (b) for the items on this agenda, if this agenda is completed in accordance with Article 533ter of the Company Code and published after the date at which the shareholder has sent the present form to the above mentioned address. Shareholders who vote by correspondence may attend the meeting but will not be permitted to vote in person or by proxy.
Done in …………………………, on ………………………………. 2012
Signature
Enclosure : Agenda of the Ordinary general meeting of May 31, 2012
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