Power of Attorney.doc Power of Attorney
POWER OF ATTORNEY
Attendance at the Annual General Meeting of Shareholders
And Extraordinary General Meeting of Shareholders
(“MEETING”)
PT. CATUR SENTOSA ADIPRANA Tbk
domiciled in West of Jakarta
On 10 May 2017
I/We, the undersigned :
Name
Address
Identification Number
: [if the Shareholders is in personal]
:
:
Name
: [if the Shareholders is in the form of legal entity)
Title
:
Address
:
Identification Number
:
-in this matter acting as my/our capacity to represent [Shareholder’s name], as
shareholders of PT. CATUR SENTOSA ADIPRANA Tbk (“Company”), as holder of
[number of shares owned of shareholders] Shares in Company, hereinafter referred to
as “Authorizer”
Has hereby granted powers to
:
Name
:
Address
:
Identification Number
:
-hereinafter referred to as “Proxy Holder”
ESPECIALLY
To attend and cast a vote in accordance with the number of shares as mentioned
above, at the MEETING to be held in Jakarta, on 10 May 2017.
The power of attorney was made in good faith and is given to be used as the abovementioned purposes.
Date
Signature of Shareholder
Name
: [dd-mm-yy]
: [stamp duty Rp. 6,000.- and signature]
: [full name of Authorizer]
Date
Signature of Proxy Holder
Name
: [dd-mm-yy]
: [signature]
: [full name of Proxy Holder]
Note
1.
:
This Power of Attorney has to be received by the Company no later than 3 May
2017 via the Office of the Share Register PT. Datindo Entrycom, Jl. Hayam
Wuruk No. 28, Jakarta 10120, Telephone +62 21 3508077, Fax +62 21
3508078.
2. The Proxy Holder who will attend the MEETING is requested to carry and show
his/her Resident’s ID Card (“KTP”) or any other Identification Card and to
provide a photocopy of the ID Card to the register officer before entering the
meeting room.
3. For the legal entity shareholders, it is required to provide the copy of Article
Association and its Amendments of the latest composition of their Board of
Director and Commisioners with its approval and receipt of notification letter
from the Ministry of Law and Human Rights of Republic of Indonesia.
Attendance at the Annual General Meeting of Shareholders
And Extraordinary General Meeting of Shareholders
(“MEETING”)
PT. CATUR SENTOSA ADIPRANA Tbk
domiciled in West of Jakarta
On 10 May 2017
I/We, the undersigned :
Name
Address
Identification Number
: [if the Shareholders is in personal]
:
:
Name
: [if the Shareholders is in the form of legal entity)
Title
:
Address
:
Identification Number
:
-in this matter acting as my/our capacity to represent [Shareholder’s name], as
shareholders of PT. CATUR SENTOSA ADIPRANA Tbk (“Company”), as holder of
[number of shares owned of shareholders] Shares in Company, hereinafter referred to
as “Authorizer”
Has hereby granted powers to
:
Name
:
Address
:
Identification Number
:
-hereinafter referred to as “Proxy Holder”
ESPECIALLY
To attend and cast a vote in accordance with the number of shares as mentioned
above, at the MEETING to be held in Jakarta, on 10 May 2017.
The power of attorney was made in good faith and is given to be used as the abovementioned purposes.
Date
Signature of Shareholder
Name
: [dd-mm-yy]
: [stamp duty Rp. 6,000.- and signature]
: [full name of Authorizer]
Date
Signature of Proxy Holder
Name
: [dd-mm-yy]
: [signature]
: [full name of Proxy Holder]
Note
1.
:
This Power of Attorney has to be received by the Company no later than 3 May
2017 via the Office of the Share Register PT. Datindo Entrycom, Jl. Hayam
Wuruk No. 28, Jakarta 10120, Telephone +62 21 3508077, Fax +62 21
3508078.
2. The Proxy Holder who will attend the MEETING is requested to carry and show
his/her Resident’s ID Card (“KTP”) or any other Identification Card and to
provide a photocopy of the ID Card to the register officer before entering the
meeting room.
3. For the legal entity shareholders, it is required to provide the copy of Article
Association and its Amendments of the latest composition of their Board of
Director and Commisioners with its approval and receipt of notification letter
from the Ministry of Law and Human Rights of Republic of Indonesia.