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20241128_MASA_Penyampaian Bukti Iklan_31792230_lamp3.pdf
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Shareholders are requested to vote on 1 (one) resolution proposed at the Second EGMS, namely the resolution in relation to the change of the Company’s status from a public company to a private company (go private), requiring the approval of more than 1/2 of all Shares held by Independent Shareholders who attend the Second EGMS.
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POWER OF ATTORNEY FORM
POWER OF ATTORNEY TO ATTEND SECOND EXTRAORDINARY GENERAL MEETING OF
SHAREHOLDERS (“SECOND EGMS”) PT MULTISTRADA ARAH SARANA TBK (THE “COMPANY”)
The undersigned:
Name (1) : _____________________
Identity Card No. : _____________________
Address : _____________________
In this matter acting as owner / in his / her capacity as (2) _____________ (3) _________________ (4)
domiciled in _________________ (5) as the owner of ________________________ (6) Shares in the
Company (“Authorizer”); hereby authorizes (7):
Name : _____________________
Identity Card No. : _____________________
Address : _____________________
and / or
Name : _____________________
Identity Card No. : _____________________
Address : _____________________
and / or
Name : _____________________
Identity Card No. : _____________________
Address : _____________________
Vote (8)
Resolution
Agree Disagree Abstain
Agenda/Resolution of Second EGMS
Approval of the plan to change the Company’s status from
a public company to a private company (“Go Private
Plan”), which includes:
(a) ratification of the appointment of an Independent
Appraiser For Go Private Plan and approval of the
Share Valuation Report;
(b) approval of the change in the Company's status from
a public company to a private company;
(c) approval of Delisting from IDX;
(d) approval on the amendment of the entire Articles of
Association in connection with the change of the
Company's status from a public company to a private
company; and
(e) authorizing the Board of Directors to take all
necessary actions to implement the Go Private Plan.
Tick (√ ) in the box provided to state your choice.
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I / we declare that I / we am / are the Independent Shareholder(9) of the Company.(10) If it is later
proven that this statement is not true, then I / we may be subject to sanctions in accordance with
the prevailing laws and regulations.
I / we hereby declare that I / we have read the Disclosure of Information to Shareholders.
This Power of Attorney is granted subject to the following terms and conditions:
(a) This Power of Attorney is a power of attorney that can always be used in connection with the
Agenda of the Second EGMS, such that it will remain effective for the continuance of the
Second EGMS with the same agenda unless it is canceled through a written notice to the
Company by the Authorizer.
(b) Each of the votes cast by the Proxy or its substitutes pursuant to the instructions (as evidenced
by the mark (√) next to each item on the agenda) which are given by the Authorizer will be
valid, binding and enforceable against the Authorizer, and this Power of Attorney cannot be
revoked or canceled for any reason; and yet if the Authorizer does not provide instructions as
set out above, then the Proxy is deemed to have been given the power and authority to not
cast a vote (abstention) or approve or reject the decision or, at its discretion, with respect to
any and all of the Second EGMS agenda, and the votes cast shall be valid, binding and
enforceable against the Authorizer. This Power of Attorney is given with the rights of
substitution or the right to transfer the authority granted under this Power of Attorney to a
third party (including to sign the required statement letters), but the transfer will only be
given as a whole, and not in part.
(c) the Authorizer agrees to indemnify and protect the Proxy from all claims, liabilities, costs and
expenses incurred due to any reason whatsoever, including negligence, whether lodged
against or suffered by the Authorizer or any third party associated with and, whether directly
or indirectly, arising from the implementation of the authority given through this Power of
Attorney.
(d) the Authorizer represents and warrants that the Power of Attorney is signed without any
pressure and/or under duress from any parties.
This Power of Attorney is signed by the Authorizer on the date stated below.
Date __________________
[stamp duty Rp10.000]
______________________
Authorizer
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Filling Instructions:
(1) Fill in the name, identity card number and address of the party who signed the Power of
Attorney, acting on its own behalf or on behalf of an institution or company.
(2) For individual Shareholders, delete the phrase “acting in his / her capacity as” and ignore
instructions No. (3), No. (4) and No. (5).
(3) Specify the position of the signatory.
(4) Specify the name of the company or institution that owns the Shares.
(5) Indicate the domicile of the company or institution.
(6) Indicate the total number of Shares owned by the Authorizer.
(7) Indicate the name, identity card number and address of the Proxies, if there are other
appointed Proxies.
(8) Mark with (√) in the appropriate box to indicate the selected votes that are to be issued in the
Second EGMS.
(9) Based on the Financial Services Authority Regulation Number 15/POJK.04/2020 on the Plan
and Implementation of the General Meeting of Shareholders of Public Companies,
Independent Shareholders are Shareholders who do not have a personal economic interest
in connection with a particular transaction and: (a) are not members of the board of directors,
board of commissioners, major shareholders and controlling shareholders; or (b) are not
Affiliates of the members of the board of directors, members of the board of commissioners,
major shareholders, and controlling shareholders.
(10) Delete if this statement is not true. If this statement is deleted, the shareholder is not
considered as independent shareholder.
Any Parties who are registered as the Shareholders who are entitled to attend and cast votes can
only cast the same vote for all Shares registered under his or her name.
Notes:
(i) All Power of Attorney may be delivered through email: MASA.corpsec@michelin.com. The
original of the Power of Attorney must have been received by the Board of Directors of the
Company the latest by 3 (three) Business Days prior to the date of the Second EGMS, on
Friday, 29 November 2024 at the office of the Company’s Share Registrar PT Raya Saham
Registra, domiciled in Jakarta, and having its addressed at Gedung Plaza Sentral, Lt.2 Jl.
Jend. Sudirman Kav. 47-48 Jakarta 12930.
(ii) the Proxy who attends the Second EGMS is required to bring and show his/her ID Card or
other proof of identity and submit a copy to the registration officer before entering the
Second EGMS room.
Names mentioned 4 people and organisations named in the text · linked when the evidence is strong
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Identity Card
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Financial Services Authority
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PT Raya Saham Registra
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