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PROXY FORM for the 2022 SHAREHOLDERS 'MEETING of
"QUARNA A COUNTRY FOR MUSIC"

The undersigned, MEMBER of Quarna Musica

First name

Surname

E-mail

Phone

Born on

Address

DELEGATES Mr. / to represent him at the Shareholders' Meeting of 19 September

© 2020 by Quarna a Country for Music Piazza Municipio, 3
28896 Quarna Sotto VB - Italy

quarnamusica@gmail.com