Siguldas CMAS — Proxy Solicitation & Information Statement 2016

Mar 21, 2016

Form of power of attorney

According to the Clause 54 Part two Point one of 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 interests of principal at

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

Date of shareholders meeting and type - annual or extraordinary general meeting

Of joint stock company "Siguldas ciltslietu un mākslīgā apsēklošanas stacija" (registration number: 40003013295, legal address: "Kalnabeites" 8, Siguldas pagasts, Siguldas novads, LV-2150)

with _________________________________________________________________________________________________________________________________________________________________________

The power of attorney is issued ______________________________________________________________________________________________________________________________________________ (with or without)

The power of attorney shall continue effective

(date)

Principal - natural person: signature Principal - legal person: signature, stamp