PROXY FORM

ACCOUNT_JOB_COMPANY
ACCOUNT_COMPANY_REG_NO

DATE GENERAL MEETING

For use by shareholders for the General Meeting to be held on DATE at ADDRESS

I/We* (block capitals) ………………………………………of ……………………………………………………….……………….….………………………………………………………………. being (a) holder(s) of ………………… ordinary shares of CURRENCYPAR each in the capital of the Company, hereby appoint the Chairman or failing him, ………………………………………………………………………… as my/our* proxy to vote for me/us* and on my/our* behalf at the General Meeting of the Company to be held on DATE and at any adjournment thereof.

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