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As Of Filer Filing For·On·As Docs:Size Issuer Agent 9/17/15 LPBP Inc 6-K 9/17/15 5:79K e3 Fil… Computershare/FA |
Document/Exhibit Description Pages Size
1: 6-K Report of Foreign Private Issuer Dated September HTML 12K
17, 2015
2: EX-99.1 Letter to Shareholders HTML 8K
3: EX-99.2 Notice of Special Meeting on October 14, 2015 HTML 8K
4: EX-99.3 Information Circular for Special Meeting on HTML 39K
October 14, 2015
5: EX-99.4 Form of Proxy HTML 15K
| Exhibit 99.4 |
Exhibit 99.4
| LPBP INC. |
|
| Security Class | |
| Holder Account Number |
Form of Proxy - Special Meeting of Shareholders to be held on October 14, 2015
This Form of Proxy is solicited by and on behalf of Management.
| Notes to proxy | |
| 1. |
Every holder has the right to appoint some other person or company of their choice, who need not be a holder, to attend and act on their behalf at the meeting or any adjournment or postponement thereof. If you wish to appoint a person or company other than the persons whose names are printed herein, please insert the name of your chosen proxyholder in the space provided (see reverse). |
| 2. |
If the securities are registered in the name of more than one owner (for example, joint ownership, trustees, executors, etc.), then all those registered should sign this proxy. If you are voting on behalf of a corporation or another individual you must sign this proxy with signing capacity stated, and you may be required to provide documentation evidencing your power to sign this proxy. |
| 3. |
This proxy should be signed in the exact manner as the name(s) appear(s) on the proxy. |
| 4. |
If this proxy is not dated, it will be deemed to bear the date on which it is mailed by Management to the holder. |
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| |
| 5. |
The securities represented by this proxy will be voted as directed by the holder, however, if such a direction is not made in respect of any matter, this proxy will be voted as recommended by Management. |
| 6. |
The securities represented by this proxy will be voted in favour or withheld from voting or voted against each of the matters described herein, as applicable, in accordance with the instructions of the holder, on any ballot that may be called for and, if the holder has specified a choice with respect to any matter to be acted on, the securities will be voted accordingly. |
| 7. |
This proxy confers discretionary authority in respect of amendments or variations to matters identified in the Notice of Meeting or other matters that may properly come before the meeting or any adjournment or postponement thereof. |
| 8. |
This proxy should be read in conjunction with the accompanying documentation provided by Management. |
Proxies submitted must be received by 5:00 pm, Eastern Time, on October 9, 2015.
| Appointment of Proxyholder | ||||
| The undersigned shareholder of the Company hereby appoints Neil J. Gotfrit, a Director of the Company or failing him, Rocco Marcantonio, Secretary | OR | Print the name of the person you are appointing if this person is someone other than the Management Nominees listed herein. | ||
as my/our proxyholder with full power of substitution and to vote in accordance with the following direction (or if no directions have been given, as the proxyholder sees fit) and all other matters that may properly come before the Special Meeting of Shareholders of LPBP Inc. (the "Company") to be held at 447 March Road, Ottawa, Ontario, on October 14, 2015 at 11:00 a.m. and at any adjournment thereof.
VOTING RECOMMENDATIONS ARE INDICATED BY HIGHLIGHTED TEXT OVER THE BOXES.
| For | Against | |
| 1. Approval of Voluntary Dissolution | ¨ | ¨ |
| To consider and, if thought advisable, approve the special resolution, as more particularly set forth in the accompanying Management Information Circular prepared for the purpose of the Meeting, approving the voluntary dissolution of the Company. | ||
| Authorized Signature(s) - This section must be completed for your instructions to be executed. | Signature(s) | Date | |||
| I/We authorize you to act in accordance with my/our instructions set out above. I/We hereby revoke any proxy previously given with respect to the Meeting. If no voting instructions are indicated above, this Proxy will be voted as recommended by Management. | DD / MM / YY | ||||
| L P B Q | 2 1 4 0 8 4 | A R 0 |
| This ‘6-K’ Filing | Date | Other Filings | ||
|---|---|---|---|---|
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| 10/14/15 | 6-K | |||
| 10/9/15 | ||||
| Filed on / For Period End: | 9/17/15 | |||
| List all Filings | ||||
