HansaMatrix — Proxy Solicitation & Information Statement 2018

Nov 16, 2018

---

title: "Form of power of attorney"
author: "Martins_Zemzaris"
date: 2018-01-14 10:20:00+00:00
processor: python-docx+mammoth
status: success

---

Form of power of attorney

according to the Clause 54 Part two Point one of the Financial instruments market law

___________________________

Place and date of issuance

Power of attorney

_____________________________________________________________________________

Natural person (name, surname, personal identification number or date of birth, place of residence) or legal person (company name, registration number, legal address, representative, grounds of representation) as principal

authorizes

_____________________________________________________________________________

Natural person (name, surname, personal identification number or date of birth, place of residence) or legal person (company name, registration number, legal address) as proxy

______to represent the interests of principal at________

(the exact scope of competence can be specified if needed)

_____________________________________________________________________________

Date of the shareholders’ meeting and type – annual or extraordinary general meeting

of the Joint Stock Company „HansaMatrix” (registration number: 40003454390, legal address: Akmeņu iela 72, Ogre, Latvia, LV-5001)

with ______________________________________________ shares belonging to the principal.

(all or specifying an exact amount of shares)

The power of attorney is issued ______________ subdelegation rights.

(with or without)

The power of attorney shall continue effective _____________________.

(date)

______________________

Principal – natural person – signature, name, surname

Principal – legal person – position of representative, signature, name, surname, stamp.