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(1) I/We Nationality Address Soi Road Tambol/Khwaeng Amphur/Khet Province Postal Code
(2) Being a shareholder The Thai Setakij Insurance Public Company Limited
Holding the total amount of share and have the rights to vote equal to votes as follows: Ordinary share share and have the rights to vote equal to share Preference share share and have the rights to vote equal to share
(3) Hereby appoint 1. Name age year, residing at
Soi Road Tambol/Khwaeng Amphur/Khet Province Postal Code or
2. Name age year, residing at Soi Road Tambol/Khwaeng Amphur/Khet Province Postal Code or
3. Name age year, residing at Soi Road Tambol/Khwaeng
Amphur/Khet Province Postal Code or 4. Mr. Jumpot Saisunthorn Independent Director age 61 years
Reside at 48 Soi Thoet Thai 59/1, Bang Wa, Phasi Charoen, Bangkok. 5. Pol.Gen. Prung Boonpadung Independent Director age 70 years
Reside at 93/5 Moo 2, Sai Ma Subdistrict, Mueang Nonthaburi District Nonthaburi.
Only one of them as my/our proxy to attend and vote on my/our behalf at the meeting of the Extraordinary General Meeting of Shareholders No. 1/2019 on June 28, 2019 at 14.00 p.m., at the meeting room 1st floor, Thai Setakij Building, No. 160, North Sathorn Road, Silom Sub-district, Bangrak District, Bangkok 10500, Thailand or such other date, time and place as the meeting may be adjourned.
(4) In this Meeting, I/We grant my/our proxy to vote on my/our behalf as follows:
สงทสงมาดวย 5
Agenda 1 To consider certifying the minutes of the 2019 Annual General Meeting of Shareholders (a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects.
(b) To grant my/our proxy to vote at my/our desire as follows: Approve Disapprove Abstain
Agenda 2 To consider approving the reduction of the Company’s registered capital from THB 1,326,518,451 to THB 1,081,754,992 by cancelling 244,763,459 authorized but unissued ordinary shares, at par value of THB 1.00 each
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 3 To consider approving the amendment of Clause 4 of the Memorandum of Association to be in line
with the reduction of the Company’s registered capital (a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 4 To consider approving the reduction of the Company’s registered capital by THB 540,877,496 from the
existing registered capital of THB 1,081,754,992 to THB 540,877,496 by reduction of par value of share from THB 1.00 each to THB 0.50 each in order to offset with the discount on common shares and partial of deficits
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 5 To consider approving the amendment of Clause 4 of the Memorandum of Association to be in line
with the reduction of the Company’s registered capital (a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 6 To consider approving the increase in the Company’s registered capital in the amount not exceed to
THB 1,244,018,240.50 from THB 540,877,496 to not exceed THB 1,784,895,736.50 by 1) issuing 2,163,509,984 newly issued ordinary shares, with a par value of THB 0.50 each by Right Offering and 2) issuing newly issued ordinary shares by General Mandate by Right Offering at the amount not exceed to 324,526,497 shares (30 percent of paid-up capital of THB 1,081,754,992 on the date that the Board of Directors resolves to increase share capital under a general mandate at par value of THB 1.00 each, after the reduction of par value from THB 1.00 each to THB 0.50 each, as a result the Company to register a capital increase not exceed THB 162,263,248.50 from the shares not exceed 324,526,497)
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain
สงทสงมาดวย 5
Agenda 7 To consider approving the amendment of Clause 4 of the Memorandum of Association to be in line with the increase of the Company’s registered capital by Right Offering
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 8 To consider approving share allotment by Right Offering (a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects.
(b) To grant my/our proxy to vote at my/our desire as follows: Approve Disapprove Abstain
Agenda 9 To consider approving the General Mandate by Right Offering
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 10 To consider approving the amendment of Clause 4 of the Memorandum of Association to be in line
with the increase of the Company’s registered capital by General Mandate by Right Offering (a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects.
(b) To grant my/our proxy to vote at my/our desire as follows: Approve Disapprove Abstain
Agenda 11 To consider approving the assignment to the Company’s Board of Directors to process in any matters that may relate to share subscription and share allotment. (a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 12 To consider approving the amendment to Article 30 the Board of Directors Meeting via video
conference and Article 46 of the Articles of Association of the Company for change of the Company’s seal to be consistent with the Company’s seal
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain Agenda 13 To consider other mattes (if any)
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
Approve Disapprove Abstain (5) Vote of the proxy in any Agenda which is not in accordance with this Form of Proxy shall be invalid and
shall not be the vote of the Shareholder. (6) In case I/we have not specified my/our voting intention in any agenda or not clearly specified or in case the
meeting considers or passes resolutions in any matters other than those specified above, including in case there is any amendment or addition of any fact, the proxy shall have the right to consider and vote on my/our behalf as he/she may deem appropriate in all respects.
สงทสงมาดวย 5
All deeds and acts made in the meeting, save where the Proxy has not voted as specifically indicated in my authorization, shall deem as though deeds and acts re made by I myself in all respects.
Signed …………………………………………………………….. Grantor
(…………………………………………………………..) Signed ……………………………………………………..….….. Proxy
(……….………………………………………………..)
Signed ……………………………………………………..….….. Proxy (……….………………………………………………..)
Signed ……………………………………………………..….….. Proxy (……….………………………………………………..)
Remark
1. The shareholder may appoint only one Proxy to attend and vote at the meeting and may not split the number of shares to more than one proxy for splitting votes.
2. In case there is any further agenda apart from specified above brought into consideration in the Meeting, the proxy holder may use the Supplemental Proxy Form as enclosed 5
สงทสงมาดวย 5
Supplemental Proxy form B. The proxy is granted by a shareholder of The Thai Setakij Insurance Public Company Limited
For the Extraordinary General Meeting of Shareholders No. 1/2019 on June 28, 2019 at 14.00 p.m., at the meeting room 1st floor, Thai Setakij Building, No. 160, North Sathorn Road, Silom Sub-district, Bangrak District, Bangkok. 10500,
Thailand or such other date, time and place as the meeting may be adjourned.
Agenda........... Subject............................................................................ ............................................................... (a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
(a) To grant my/our proxy to consider and vote on my/our behalf as appropriate in all respects. (b) To grant my/our proxy to vote at my/our desire as follows:
To elect of all directors Approve Disapprove Abstain
To elect of director in individual Name of the Director