PROXY ATTENDANCE FORM
_________________________________
(first and last name/company name of the shareholder) _________________________________________ (shareholder personal registration number – EMŠO / registration number) _________________________________________ (shareholder address/seat) _________________________________________ (first and last name of shareholder's statutory representative, if the shareholder is a legal person)
Pivovarna Laško, d.d. Trubarjeva 28 3270 Laško
ATTENDANCE APPLICATION for the 24th General Meeting of the company Pivovarna Laško, d.d., Trubarjeva 28, 3270 Laško Shareholder (first and last name/company name)_________________________________ _________________________________________________________, personal registration number – EMŠO / registration number: ________________________________________, (address/seat) ________________________________________, hereby register my attendance at the 24th General Meeting of the company Pivovarna Laško, d.d., Trubarjeva 28, 3270 Laško, taking place on Thursday, November 12, 2015, at 09:00, in the main hall of the Laško Cultural Centre, Trg svobode 6, Laško. I shall be represented at the General Meeting by a proxy. Proxy authorization form is attached herewith. In _________________, on this _______________ (place) (date) _______________________ _____
(shareholder first and last name/company name and
signature of shareholder or statutory representative and stamp for legal person)