Certificated Corporate / Partnership Stockholders

Corporate

Company Name (required) *

Name of Authorized Representative (required) *

Email Address of Authorized Representative (required) *

Contact Number of Authorized Representative (required) *

Stock Certificate Number

Government IDs (Passport, Driver's License, Unified Multipurpose ID) *

Maximum upload size: 516MB

Secretary’s Certification of Board Resolution (required) *

Maximum upload size: 516MB

The Company attests to the truth and veracity of the information provided above. The Company hereby appoints the Chairman of the Board to act as our proxy and vote accordingly in all matters to be discussed in the Annual Stockholders’ Meeting in the event The Company is not able to cast vote.