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Tessellis — Proxy Solicitation & Information Statement 2016
Mar 25, 2016
4246_egm_2016-03-25_d48d39d9-4819-4dc9-acee-3833794e9c89.pdf
Proxy Solicitation & Information Statement
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TISCALI S.p.A. – Ordinary and Extraordinary shareholders' meeting of April 28 2016 – Proxy Form
| Complete with the information required, sign and send to the Company based on the Instructions shown in the footnotes1 | ||||
|---|---|---|---|---|
| Mr./Mrs. 2………… resident in (city) ………………………………… in (street) |
born in on Tax Code ………………………… ……………………………………………………………………………… |
|||
| holder of no. Tiscali shares deposited in securities account3 as per communication no.4 …………………………sent by ………………………………………………………………………… DELEGATES 5……………………………………………………………………………………………………… |
no. …………………….… at ………………………………………………. ABI (bank code)…………… CAB (sort code)….……… | |||
| to attend and represent him/her at the ordinary in Cagliari, Località Sa Illetta, s.s. 195 km. 2,3 in single call. The undersigned 6 ………………………………………………………………………………… DECLARES that he/she is the holder of voting rights pertaining to the above-mentioned shares and is signing this proxy as (tick the necessary box): legal representative - proxy with substitute agent powers - other (specify) ………………… |
and extraordinary secured creditor - |
shareholders' meeting of Tiscali S.p.A. called for April 28 contango broker - usufructuary - |
2016 at 11 custodian - manager - |
am at the registered office |
| 7 DATE Identity document (type) |
………………….…. | issued by ………………… |
no. ………………………. |
SIGNATURE |
Instructions for compilation and transmission
1 The original Proxy form must be sent to the delegate and delivered by the latter to the Company upon confirmation. It is also possible to send a copy of the proxy in advance directly to the Company via:
fax to the no. +39.070.460.1482
an attachment to a certified e-mail to the address: [email protected].
Any prior notification of the proxy does not exempt delegates, at the time of validation for access to shareholders' meetings, from the obligation to certify, under their own responsibility, compliance of the original proxy and the identity of the delegating party.
2 Indicate name and surname or name of the nominee of the shares as shown in the communication sent by the intermediary to the Company.
3 Quote the number of the securities account, the ABI and CAB numbers of the depositary intermediary, or, in any case, its name, taken from the statement of the securities portfolio.
4 Any reference to the communication sent by the intermediary and his/her name, if different from the depositary of the securities account.
5 Indicate the name and surname of the proxy.
6 Indicate the name and surname of the signatory holding the voting right and his/her capacity only if different from the share nominee stated above.
7 Quote the references of a valid identity document of the signatory of the proxy.