Proxy Form 2015 EGY AGM
Released
Released
Announcement PDF
Proxy Form 2015
Energy Technologies Limited ("the Company")
ABN 38 002 679 469
I/We being a
member/s of the
Company and
entitled to attend and
vote
of
Hereby appoint
of
or failing him/her, or if no person is named, the Chairman of the Meeting, as my/our proxy to attend and to vote on
my/our behalf at the Annual General Meeting of the Company to be held at 102 Old Pittwater Road, Brookvale on
19 November 2015 at 10.30am, and at any adjournment thereof.
If this appointment of proxy appoints the Chairman of the meeting, then I/we authorise the Chairman to exercise
the proxy even if the resolution is connected directly or indirectly with the remuneration of a member of the Key
Management Personnel of the Company or the consolidated entity.
If two proxies are appointed, the proportion of the member’s voting rights which this proxy is appointed to
represent is set out below.
%
or
shares
Instructions on Voting
If you wish to direct your proxy how to vote in respect of the proposed resolutions, please indicate the manner in
which your proxy is to vote by ticking the appropriate box below, otherwise your proxy may vote as he/she thinks
fit.
Should you chose to appoint a proxy, you are encouraged to direct that proxy as to how to vote by marking either
For, Against or Abstain on the proxy form for each item of business.
If you mark the abstain box for a particular item you are directing your proxy not to vote on a show of hands or on
a poll and your votes will not be counted in computing the required majority on a poll on that item.
The Chairman of the Meeting intends to vote undirected proxies by shareholders who are not Excluded
Shareholders in favour of Resolution 1 and all undirected proxies in favour of resolution 2.
Any undirected proxies held by any other member of the Company's Key Management Personnel or any of their
Closely Related Parties, or a Director of the Company or an associate of that Director (other than a Director who
is ineligible to participate in any employee incentive scheme in relation to the Company) will not be voted on
Resolution 1.
Any undirected proxies held by the Chairman of the Meeting will not be voted on Resolutions 3 and 4.
"Key Management Personnel" of the Company are those persons having authority and responsibility for
planning, directing and controlling the activities of the Company, directly or indirectly, including any Director
(whether executive or non-executive) of the Company. A "Closely Related Party" of Key Management Personnel
is a term defined in the Corporations Act and includes close family members, such as the children or spouse of
the relevant Key Management Personnel, companies that person controls and other members of that person's
family who may be expected to influence, or be influenced by, that person in that person's dealings with the
Company.
ORDINARY BUSINESS
For
Against
Abstain
RESOLUTION 1
Adoption of Remuneration Report
RESOLUTION 2
Re-election of Director – Phillip W Dulhunty
SPECIAL BUSINESS
For
Against
Abstain
RESOLUTION 3
Approval for issue to and conversion of convertible notes by Auster Holdings Pty
Ltd
RESOLUTION 4
Issue of convertible notes under an unsecured convertible note facility
RESOLUTION 5
Approval of issue of convertible notes to interests associated with Alfred J
Chown
RESOLUTION 6
Approval of issue of convertible notes to interests associated with Gary A
Ferguson
RESOLUTION 7
Ratification of completed issue of ordinary shares to Auster Holdings Pty Ltd
RESOLUTION 8
Approval under listing rule 7.1A to issue additional shares in the company
RESOLUTION 9
Issue of ordinary shares to interests associated with Mr Alfred J Chown
RESOLUTION 10
Issue of ordinary shares to interests associated with Mr Gary A Ferguson
Dated this _______ day of _____________________ 2015
INDIVIDUAL SECURITY HOLDER
SECURITY HOLDER
SECURITY HOLDER
Signature
Signature
Signature
DIRECTOR / COMPANY
SECRETARY
SOLE DIRECTOR / SOLE COMPANY
SECRETARY
Signature
Signature
Address for return of proxies: 102 Old Pittwater Road, Brookvale or fax to +61 (2) 9939 9812 Attention: Gregory
Knoke.
This form must be signed by the security holder. If a joint holding, all security holders must sign. If signed by the
security holder’s attorney, the power of attorney must have been previously noted by the Company or a certified copy
attached to this form. If executed by a company, the form must be executed in accordance with the security holder’s
constitution and the Corporations Act 2001 (Cth).
The Company advises that Chapter 2C of the Corporations Act 2001(Cwlth) requires information about you as a
security holder (including your name, address and details of securities you hold) to be included in the public register
of the entity in which you hold securities. This information must continue to be included in the Company's register of
members even if you cease to be a security holder. Information is collected to administer your security holding and if
some or all of the information is not collected then it might not be possible to administer your security holding. The
Company may disclose this information for purposes related to your shareholding, including in circumstances
permitted under the Chapter 2C of the Corporations Act 2001. You can obtain access to your personal information in
the Company's register of members in accordance with Chapter 2C of the Corporations Act 2001.
page 2
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