Proxy Form A (Simple Form)
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1PROXY FORM A (SIMPLE FORM)
According to Regulation of Department of Business Development
Re: Form of Proxy (No. 5) B.E. 2550
Written at ____________________________________
Date ____ Month __________________ Year ______
(1) I / We
Nationality
with address at ___________________________ Road ____________________________ Sub-District ______________________
District ___________________________________ Province __________________________ Postal Code __________________
(2) being a shareholder of Matichon Public Company Limited
holding the total amount of
shares with the voting rights of
votes as follows;
ordinary share
shares with the voting rights of
votes
preferred share
-
shares with the voting rights of
-
votes
(3) do hereby appoint either one of the following persons:
(1) ________________________________________________________________________________
Age _____ Years
with address at ___________________________ Road ____________________________ Sub-District ______________________
District ___________________________________ Province __________________________ Postal Code __________________ or
(2) ________________________________________________________________________________
Age _____ Years
with address at ___________________________ Road ____________________________ Sub-District ______________________
District ___________________________________ Province __________________________ Postal Code __________________ or
(3) ________________________________________________________________________________
Age _____ Years
with address at ___________________________ Road ____________________________ Sub-District ______________________
District ___________________________________ Province __________________________ Postal Code __________________
as only one of my / our proxy to attend and vote on my / our behalf at the Ordinary General Meeting of Shareholders
No. 1/2007 to be held on Friday, April 27, 2007, 09.30 a.m. at Conference room, on the 9 th floor of the Matichon Public
Company Limited No. 12 Tethsabannaruemarn Road, Prachanivate 1 Kwaeng Ladyao , Khet Chatuchak , Bangkok 10900 or
at any adjournment thereof to any other date ,time and venue.
For any act performed by the Proxy at the meeting, it shall be deemed as such acts had been done by me / us in all
respects.
Signed _____________________________________ Shareholder
(
)
Signed _____________________________________ Proxy
(
)
Signed _____________________________________ Proxy
(
)
Signed _____________________________________ Proxy
(
)
Remarks:
The Shareholder appointing the Proxy must authorize only one proxy to attend and vote at the meeting and shall not allocate
the number of shares to several proxies to vote separately.
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