Pozavarovalnica Sava

Proxy Solicitation & Information Statement • Aug 1, 2016

---

title: "_____________"
author: "Nika Matjan"
date: 2015-10-13 09:40:00+00:00
processor: python-docx+mammoth
status: success

---

_____________________________________________________________________________________

(Shareholder details: name or company name)

_____________________________________________________________________________________

(Address)

_____________________________________________________________________________________

(Town and postal code)

Pozavarovalnica Sava, d.d.

Dunajska 56

1000 Ljubljana

PROXY FORM FOR ATTENDANCE AT THE

31st GENERAL MEETING OF SHAREHOLDERS OF

POZAVAROVALNICA SAVA, d. d.

I, the undersigned _________________________________________________,

Name or company name of shareholder and name of legal representative

hereby appoint

______________________________________________________________

Name and residence of proxy holder

as my proxy to attend and to vote for me and on my behalf at the 31st general meeting of Sava Reinsurance Company to be held on Tuesday, 30 August 2016, at 13:00 at the Horus Hall of the Austria Trend Hotel Ljubljana, Dunajska cesta 154, 1000 Ljubljana, for __________ shares of the issuer Sava Reinsurance Company with ticker symbol POSR, the holder of which I am.

The proxy is to provide personal identification upon request.

____________________

(Place and date)

_________________________

(Signature of shareholder or legal representative with official stamp of entity, or seal if used)