Registration Form printable pdf download

REGISTRATION FORM

for North Media A/S’ Annual General Meeting on Friday 8 April 2016, at 3 p.m. at the address

Ingeniørforeningens Mødecenter A/S, Kalvebod Brygge 31-33, 1780 Copenhagen V

Request for admission cards

This registration form must be received by Computershare A/S, Kongevejen 418, 2840 Holte, Denmark at the latest by

Monday 4 April 2016, at 11.59 p.m.

Please note that admission cards will not be mailed to you until after the registration date, 1 April 2016, which is one

week before the Annual General Meeting.

PLEASE TICK:

I wish to attend the Annual General Meeting and hereby request an admission card.

I also wish to request an admission card for a companion/advisor.

Date: ______________________ Name of shareholder: _____________________________________________

Address:

_______________________________________________

Postal code and city: ______________________________________________

Account/VP account no.: __________________________________________

Signature:

_______________________________________________

NB! Your VP account number MUST be stated to identify you as a shareholder.

The VP account number is generally the same as your account number. In some cases the VP account number consists

of your bank's identification number and your account number. If in doubt, please consult your bank.

Please note that the North Media A/S and the registrar shall not be held responsible for any delay in submitting the

material. This registration form must be received by Computershare A/S, Kongevejen 418, 2840 Holte, Denmark at

the latest by Monday 4 April 2016, at 11.59 p.m., either by fax to (+45) 45 46 09 98, by ordinary mail or electronical-

ly through the Investor Portal.

Registration Form