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Selvita S.A. — Proxy Solicitation & Information Statement 2026
May 28, 2026
5808_rns_2026-05-28_bb1e99e1-98e6-49aa-bbaa-944cb606a07a.pdf
Proxy Solicitation & Information Statement
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POWER OF ATTORNEY
for representation at the General Meeting
I. SHAREHOLDER DATA
| Name: | |
|---|---|
| Address: | |
| Series and number of identity card/passport: | |
| PESEL: | |
| Phone: | |
| Email: |
II. PROXY DATA
| Name: | |
|---|---|
| Name: | |
| Series and number of identity card/passport: | |
| PESEL: | |
| Phone: | |
| Email: |
I hereby grant to the Proxy indicated above, i.e. _____, the power of attorney to represent me, a Shareholder, at the Annual General Meeting of Selvita S.A. with its registered office in Krakow, Poland, convened for June 24th, 2026.
This power of attorney authorizes the Proxy to exercise on my behalf all the rights to which I am entitled from __ shares of Selvita S.A. in accordance with the registered certificate of the right to participate in the Annual General Meeting of Selvita S.A. issued by: __ no. _____.
The proxy is authorized/not authorized¹ to appoint further proxies.
Knowing the criminal consequences of making false statements, I/we confirm that the above information is true and correct.
Additional Notes:
Place and date of issue _____
Signature of Shareholder _____
¹ Delete as necessary.