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Fab-Form Industries Ltd. — Proxy Solicitation & Information Statement 2023
Nov 9, 2023
44274_rns_2023-11-08_c611d7f3-980d-45c6-8c7d-bcffbc941def.pdf
Proxy Solicitation & Information Statement
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FORM OF PROXY
APPOINTMENT OF PROXY HOLDER:
I/We, being holder(s) of Fab-Form Industries Print the name of the person you are O Ltd. Common shares hereby appoint: D. appointing if this person is someone R Russell, or failing him, N. Protter. other than the Chairman of the Meeting
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as my/our proxy holder with full power of substitution and to attend, act and to vote for and on behalf of the shareholder in accordance with the following direction (or if no directions have been given, as the proxy holder sees fit) and all other matters that may properly come before the Annual Meeting of shareholders of Fab-Form Industries Ltd. to be held at FabForm, Unit 19, 1610 Derwent Way, Delta BC V3M 6W1 on Friday, 22 December 2023, 4:00 PM and at any adjournment or postponement thereof.
VOTING FOR RESOLUTIONS (see table below)
Voting recommendations are indicated by a ‘ ***** ’ in the box. For full details of each resolution, please see the enclosed Information Circular.
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----- Start of picture text ----- Resolution For Against Withhold 1. To receive the Annual Report of the directors to the shareholders, the Financial N/AStatements of the Company and the Auditors Report thereon 2. To appointment of auditors * N/A To authorize the Directors to fix the Auditors’ remuneration * N/A 3. To determine the number of Directors at four (4) * N/A To elect as Director, Richard Fearn N/A To elect as Director, Joseph Fearn * N/A To elect as Director, Nigel Protter * N/A* To elect as Director, Donald Russell N/A 4. A special resolution, (a) to ratify and approve the exercise of any stock-based *compensation granted in the previous year as granted hereunder. (b) to authorizeand approve the granting and exercise of stock-based compensation in the N/Aforthcoming year, subject to the approval by the TSX Venture Exchange, and (c) toauthorize the directors to renegotiate or cancel any existing stock options. 5. An ordinary resolution to grant authority to the Board of Directors to proceed with *and complete one or more private placements within the 12-month period followingthe meeting up to a maximum of 2,293,626 shares or equal to 25% of the currentN/Aoutstanding shares of the Company, and any consequential change in the effectivecontrol of the Company, provided that such placements are completed inaccordance with the policies of the TSX Venture Exchange; 6. To ratify, confirm and approve all acts, deeds and things done by and the *proceedings of the directors and officers of the Company on its behalf since the N/Alast Annual General Meeting of the CompanyAUTHORIZED SIGNATURE(S)This section must be completed for your instructions to be executed.I/We authorize you to act in accordance with my/our instructions setout above. I/We hereby revoke any proxy previously given withrespect to the Meeting. If no voting instructions are indicated above,this Proxy will be voted as recommended by Management. Signature DateInterim Financial Statements and Annual Financial StatementsIf you wish to receive the Interim and Annual Statements andManagement Discussion & Analysis by email, complete this box.Email address----- End of picture text -----
FAB-FORM INDUSTRIES LTD. , Unit 19, 1610 Derwent Way, Delta BC V3M 6W1, email: [email protected] (See next page for notes to this proxy form)
Notes to Proxy Form
For:
ANNUAL MEETING: SHAREHOLDERS OF FAB-FORM INDUSTRIES LTD.
TO BE HELD AT: Unit 19, 1610 Derwent Way, Delta BC V3M 6W1 DATE & TIME: Friday, 22 December 2023, 4:00 PM
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Every holder has the right to appoint some other person or company of their choice, who need not be a holder, to attend and act on their behalf at the meeting or any adjournment or postponement thereof. If you wish to appoint a person or company other than the persons whose names are printed herein, please insert the name of your chosen proxy holder in the space provided (see reverse).
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If the securities are registered in the name of more than one owner (for example, joint ownership, trustees, executors, etc.), then all those registered should sign this proxy. If you are voting on behalf of a corporation or another individual you must sign this proxy with signing capacity stated, and you may be required to provide documentation evidencing your power to sign this proxy.
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If this proxy is not dated, it will be deemed to bear the date on which it is mailed by Management to the holder.
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The securities represented by this proxy will be voted as directed by the holder, however, if such a direction is not made in respect of any matter, this proxy will be voted as recommended by Management.
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The securities represented by this proxy will be voted in favour or withheld from voting or voted against each of the matters described herein, as applicable, in accordance with the instructions of the holder, on any ballot that may be called for and, if the holder has specified a choice with respect to any matter to be acted on, the securities will be voted accordingly.
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This proxy confers discretionary authority in respect of amendments or variations to matters identified in the Notice of Meeting or other matters that may properly come before the meeting or any adjournment or postponement thereof.
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This proxy should be read in conjunction with the accompanying documentation provided by Management.
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Proxies submitted must be received no later than forty-eight hours, excluding Saturdays, Sundays, and holidays, prior to the time of the meetings or adjournment thereof.
Fab-Form Industries Ltd.
Unit 19, 1610 Derwent Way, Delta BC V3M 6W1 604.596.3278