(i) |
Notice and Proxy Statement with respect to the Meeting, which describes the proposals to be voted on at the Meeting, the procedure for voting in person or by proxy at the Meeting and various other details related to the Meeting; and
|
(ii) |
Proxy Card whereby holders of ordinary shares, par value NIS 0.1 per share, of the Company may vote at the Meeting without attending in person.
|
Exhibit No.
|
|
Description
|
|
|
|||
Enlight Renewable Energy Ltd.
|
||
Date: November 20, 2023
|
By:
|
/s/ Nir Yehuda
|
Nir Yehuda
|
||
Chief Financial Officer
|
1. |
Approve the re-appointment of Somekh Chaikin, a member firm of KPMG International, as the Company’s independent registered public accounting firm for the year
ending December 31, 2023, and until the next annual general meeting of shareholders, and to authorize the Company’s Board of Directors (the “Board”), following the approval of the Audit Committee, to approve and ratify the remuneration of such firm in accordance with the volume and nature of their services; and
|
2. |
Elect each of the following nominees to the Board of the Company, to hold office until close of the Company’s annual general meeting to be
held in 2024, and until his or her successor has been duly elected or appointed, or until his or her office has been vacated pursuant to any applicable law or the Articles of Association:
|
a. |
Mr. Gilad Yavetz;
|
b. |
Mr. Yair Seroussi;
|
c. |
Ms. Liat Benyamini;
|
d. |
Ms. Michal Tzuk;
|
e. |
Ms. Alla Felder;
|
f. |
Dr. Shai Weil;
|
g. |
Mr. Yitzhak Betzalel; and
|
h. |
Mr. Zvi Furman.
|
− |
Shareholders of record are requested to complete, date and sign the enclosed form of proxy and to return it no later than Tuesday,
December 26, 2023, at 6:59 a.m. Israel time (i.e., 11:59 p.m. ET before the General Meeting starts), in the pre-addressed envelope provided. Alternatively, such shareholders may vote
electronically before such time at www.proxyvote.com using the control number provided with your proxy materials.
|
− |
If your Ordinary Shares are held through a bank, broker or other nominee, which in turn holds the shares through Cede & Co. as nominee for The Depository
Trust Company, such Ordinary Shares are considered to be held in “street name” and you are the beneficial owner with respect to such Ordinary Shares (“Beneficial Owners”). A Beneficial Owner as of the
Record Date has the right to direct the bank, broker or nominee how to vote Ordinary Shares beneficially owned by such Beneficial Owner at the General Meeting. If your Ordinary Shares were held in “street name” as of the Record Date, these
proxy materials are being forwarded to you by your bank, broker or other nominee (who is considered, with respect to such Ordinary Shares, as the shareholder of record), together with a voting instruction card for you to use in directing the
bank, broker or nominee how to vote your Ordinary Shares.
|
− |
Shareholders registered in the Company’s shareholders register in Israel (“Registered Shareholders”) and shareholders
who hold Ordinary Shares through members of the Tel Aviv Stock Exchange (“TASE” and “TASE Member”, respectively) that are included among the Ordinary Shares
registered in the Company’s shareholders register in Israel under the name of a nominee company in Israel (“Non-registered Shareholders”) should deliver or mail (via registered mail) a completed written
ballot (in the form filed by the Company via MAGNA, the online platform of the Israel Securities Authority (“TASE Ballot”)) to the Company’s offices, c/o Ms. Lisa Haimovitz, 13 Amal St., Afek Industrial
Park, Rosh Ha’ayin 4809249, Israel no later than Wednesday, December 27, 2023, at 12:00 p.m. Israel time (i.e., at least four (4) hours before the General
Meeting starts). By this time, both Registered Shareholders and Non-registered shareholders must also provide the Company with a copy of their identity card, passport or certificate of incorporation (“Identifying
Information”). A TASE Ballot submitted by a Registered Shareholder without Identifying Information attached to it will not be valid. Non-registered Shareholders must also provide the Company with an ownership certificate confirming
their ownership of the Company’s Ordinary Shares on the Record Date, which certificate must be approved by a recognized financial institution (“Ownership Certificate”), as required by the Israel
Companies Law 5759-1999 (the “Companies Law”) and Israel Companies Regulations (Proof of Ownership of Shares for Voting at General Meeting), 5760-2000, as amended. A TASE Ballot submitted by a
Non-registered Shareholder without an Ownership Certificate attached to it will not be valid. A Non-registered Shareholder is entitled to receive the Ownership Certificate at the branch of the TASE Member through which such shareholder holds
his Ordinary Shares, or request from such TASE Member to deliver it by mail. Such a request will be provided in advance, and with respect to a specific securities account. A Non-registered Shareholder may direct the relevant TASE Member to
transfer the Ownership Certificate to the Company through the electronic voting system of the Israel Securities Authority (the “Electronic Voting System”). Alternatively, Non-registered Shareholders may vote electronically via the Electronic Voting System, no later than Wednesday, December 27, 2023, at 10:00 a.m. Israel time (i.e., at least six (6) hours before the General Meeting starts). A Non-registered Shareholder should receive instructions about electronic voting from the TASE Member
through which such Non-registered Shareholder holds his Ordinary Shares.
|
− |
Shareholders of record who intend to vote their Ordinary Shares in person are requested to bring proof of identity to the General Meeting.
|
− |
Because a Beneficial Owner with shares held in “street name” is not a shareholder of record, such shareholders may not vote those Ordinary Shares directly at
the General Meeting unless they obtain a “legal proxy” from the bank, broker or other nominee that holds the Ordinary Shares directly, giving them the right to vote the Ordinary Shares at the General Meeting.
|
− |
Both Registered Shareholders and Non-registered Shareholders who intend to vote their Ordinary Shares in person must provide the Company with Identifying
Information and Non-registered Shareholders must also provide an Ownership Certificate, no later than Wednesday, December 27, 2023, at 14:00 p.m. Israel time (i.e., at least two (2) hours before the
General Meeting starts). Both Registered Shareholders and Non-registered Shareholders may revoke their proxies or TASE Ballot (as applicable) in accordance with Section 9 of the Israel Companies Law Regulations (Proxy Voting and Positions
Statements), 2005.
|
|
By Order of the Board of Directors,
Yair Seroussi
Chairman of the Board of Directors
|
1. |
Approve the re-appointment of Somekh Chaikin, a member firm of KPMG International, as the Company’s independent registered public accounting firm for the year
ending December 31, 2023, and until the next annual general meeting of shareholders, and to authorize the Company’s Board of Directors, following the approval of the Audit Committee, to approve and ratify the remuneration of such firm in
accordance with the volume and nature of their services; and
|
2. |
Elect each of the following nominees to the Board of Directors of the Company, to hold office until close of the Company’s annual general
meeting to be held in 2024, and until his or her successor has been duly elected or appointed, or until his or her office has been vacated pursuant to any applicable law or the Articles of Association:
|
a. |
Mr. Gilad Yavetz;
|
b. |
Mr. Yair Seroussi;
|
c. |
Ms. Liat Benyamini;
|
d. |
Ms. Michal Tzuk;
|
e. |
Ms. Alla Felder;
|
f. |
Dr. Shai Weil;
|
g. |
Mr. Yitzhak Betzalel; and
|
h. |
Mr. Zvi Furman.
|
− |
Shareholders of record are requested to complete, date and sign the enclosed form of proxy and to return it no later than Tuesday,
December 26, 2023, at 6:59 a.m. Israel time (i.e., 11:59 p.m. ET before the General Meeting starts), in the pre-addressed envelope provided. Alternatively, such shareholders may vote
electronically before such time at www.proxyvote.com using the control number provided with your proxy materials.
|
− |
If your Ordinary Shares are held through a bank, broker or other nominee, which in turn holds the shares through Cede & Co. as nominee for The Depository
Trust Company, such Ordinary Shares are considered to be held in “street name” and you are the beneficial owner with respect to such Ordinary Shares (“Beneficial Owners”). A Beneficial Owner as of the
Record Date has the right to direct the bank, broker or nominee how to vote Ordinary Shares beneficially owned by such Beneficial Owner at the General Meeting. If your Ordinary Shares were held in “street name” as of the Record Date, these
proxy materials are being forwarded to you by your bank, broker or other nominee (who is considered, with respect to such Ordinary Shares, as the shareholder of record), together with a voting instruction card for you to use in directing the
bank, broker or nominee how to vote your Ordinary Shares.
|
− |
Shareholders registered in the Company’s shareholders register in Israel (“Registered Shareholders”) and shareholders
who hold Ordinary Shares through members of the Tel Aviv Stock Exchange (“TASE” and “TASE Member”, respectively) that are included among the Ordinary Shares
registered in the Company’s shareholders register in Israel under the name of a nominee company in Israel (“Non-registered Shareholders”) should deliver or mail (via registered mail) a completed written
ballot (in the form filed by the Company via MAGNA, the online platform of the Israel Securities Authority (“TASE Ballot”)) to the Company’s offices, c/o Ms. Lisa Haimovitz, 13 Amal St., Afek Industrial
Park, Rosh Ha’ayin 4809249, Israel no later than Wednesday, December 27, 2023, at 12:00 p.m. Israel time (i.e., at least four (4) hours before the General
Meeting starts). By this time, both Registered Shareholders and Non-registered shareholders must also provide the Company with a copy of their identity card, passport or certificate of incorporation (“Identifying
Information”). A TASE Ballot submitted by a Registered Shareholder without Identifying Information attached to it will not be valid. Non-registered Shareholders must also provide the Company with an ownership certificate confirming
their ownership of the Company’s Ordinary Shares on the Record Date, which certificate must be approved by a recognized financial institution (“Ownership Certificate”), as required by the Israel
Companies Law 5759-1999 (the “Companies Law”) and Israel Companies Regulations (Proof of Ownership of Shares for Voting at General Meeting), 5760-2000, as amended. A TASE Ballot submitted by a
Non-registered Shareholder without an Ownership Certificate attached to it will not be valid. A Non-registered Shareholder is entitled to receive the Ownership Certificate at the branch of the TASE Member through which such shareholder holds
his Ordinary Shares, or request from such TASE Member to deliver it by mail. Such a request will be provided in advance, and with respect to a specific securities account. A Non-registered Shareholder may direct the relevant TASE Member to
transfer the Ownership Certificate to the Company through the electronic voting system of the Israel Securities Authority (the “Electronic Voting System”). Alternatively, Non-registered Shareholders may vote electronically via the Electronic Voting System, no later than Wednesday, December 27, 2023, at 10:00 a.m. Israel time (i.e., at least six (6) hours before the General Meeting starts). A Non-registered Shareholder should receive instructions about electronic voting from the TASE Member
through which such Non-registered Shareholder holds his Ordinary Shares.
|
− |
Shareholders of record who intend to vote their Ordinary Shares in person are requested to bring proof of identity to the General Meeting.
|
− |
Because a Beneficial Owner with shares held in “street name” is not a shareholder of record, such shareholders may not vote those Ordinary Shares directly at
the General Meeting unless they obtain a “legal proxy” from the bank, broker or other nominee that holds the Ordinary Shares directly, giving them the right to vote the Ordinary Shares at the General Meeting. Brokers that hold ordinary shares
in “street name” for clients typically have authority to vote on “routine” proposals even when they have not received instructions from beneficial owners. The only item on the General Meeting agenda that may be considered routine is Proposal
No. 1 relating to the reappointment of the Company’s independent registered public accounting firm for the fiscal year ending December 31, 2023; however, the Company cannot be certain whether this will be treated as a routine matter since the
proxy statement is prepared in compliance with the Companies Law, rather than the rules applicable to domestic U.S. reporting companies. Therefore, it is important for a shareholder that holds Ordinary Shares through a bank, broker or other
nominee to instruct its bank, broker or other nominee how to vote its Ordinary Shares, if the shareholder wants its Ordinary Shares to count for all proposals.
|
− |
Both Registered Shareholders and Non-registered Shareholders who intend to vote their Ordinary Shares in person must provide the Company with Identifying
Information and Non-registered Shareholders must also provide an Ownership Certificate, no later than Wednesday, December 27, 2023, at 14:00 p.m. Israel time (i.e., at least two (2) hours before the
General Meeting starts). Both Registered Shareholders and Non-registered Shareholders may revoke their proxies or TASE Ballot (as applicable) in accordance with Section 9 of the Companies Law Regulations (Proxy Voting).
|
☑
|
Base a portion of the compensation opportunity
of our executive officers on our and their respective performance.
|
☑
|
Annual bonuses are subject either to the
attainment of pre-set periodic objectives and individual and Company targets determined annually, or to discretionary evaluations.
|
|
☑
|
Set annual performance targets to our chief executive officer based on measurable objectives.
|
☑
|
Offer equity and cash compensation which we believe enhances alignment between executive officers’
interests with the Company’s and shareholders’ long-term interests, as well as strengthens retention and motivation of executive officers in the long-term.
|
|
☑
|
Adopted a ‘clawback policy’ and include in our Compensation Policy ‘clawback’ provisions which
allow us under certain circumstances to recoup excess incentive compensation to executive officers where the company is required to prepare a financial restatement to correct a material error.
|
☑
|
Taylor executive officers’ compensation to target our short and long-term goals, as well as each
officer’s individual performance.
|
|
☑
|
Maintain a majority independent Board of Directors.
|
☑
|
Include in our compensation policy measures
designed to reduce executive officers’ incentives to take excessive risks that may harm us in the long-term, such as limit cash bonuses and equity-based compensation, as well as the ratio between the variable and the total compensation of
an executive officer, and set minimum vesting periods for equity-based compensation.
|
|
☑
|
Maintain entirely independent audit, compensation, and environmental, social and governance
committees.
|
☑
|
Regularly review executive compensation.
|
Board Diversity Matrix
|
||||
Country of Principal Executive Offices
|
Israel
|
|||
Foreign Private Issuer
|
Yes
|
|||
Disclosure Prohibited under Home Country Law
|
No
|
|||
Total Number of Directors
|
8
|
|||
|
Female
|
Male
|
Non-Binary/Transgender
|
Did Not Disclose Gender
|
Part I: Gender Identity
|
|
|||
Directors
|
3
|
5
|
0
|
0
|
Part II: Demographic Background
|
||||
Underrepresented Individual in Home Country Jurisdiction
|
0
|
|||
LGBTQ+
|
0
|
|||
Did Not Disclose Demographic Background
|
0
|
Principal shareholders
|
Number of
Ordinary Shares
|
% of Outstanding
Ordinary Shares
|
||||||
Migdal Insurance and Financial Holdings Ltd.(1)
|
10,593,822
|
8.99
|
%
|
|||||
Harel Insurance Investments & Financial Services Ltd.(2)
|
8,054,314
|
6.83
|
%
|
|||||
Altshuler Shaham Ltd.(3)
|
6,329,326
|
5.37
|
%
|
|||||
The Phoenix Holdings Ltd.(4)
|
10,130,711
|
8.60
|
%
|
|||||
Meitav Dash Investments Ltd.(5)
|
10,995,722
|
9.33
|
%
|
|||||
Clal Investments Ltd.(6)
|
6,037,560
|
5.12
|
%
|
|||||
Menora Mivtachim Holdings Ltd. (7)
|
6,015,530
|
5.10
|
%
|
|||||
Directors and executive officers
|
||||||||
Gilad Yavetz(8)
|
1,905,470
|
1.60
|
%
|
|||||
Nir Yehuda(9)
|
319,039
|
*
|
||||||
Amit Paz(10)
|
1,578,718
|
1.33
|
%
|
|||||
Ilan Goren(11)
|
250,931
|
*
|
||||||
Michael Avidan(12)
|
88,438
|
*
|
||||||
Yair Seroussi(13)
|
347,375
|
*
|
||||||
Liat Benyamini
|
-
|
*
|
||||||
Michal Tzuk
|
-
|
*
|
||||||
Alla Felder
|
-
|
*
|
||||||
Dr. Shai Weil(14)
|
40,552
|
*
|
||||||
Yitzhak Betzalel
|
-
|
*
|
||||||
Zvi Furman
|
-
|
*
|
||||||
All executive officers and directors as a group (12 persons)
|
4,530,523
|
3.75
|
%
|
(1) |
Consists of 10,593,822 Ordinary Shares owned by Migdal Insurance and Financial Holdings Ltd. (“Migdal”) and entities
under its control. Migdal is a public company with shares traded on the TASE. To the Company's knowledge, the ultimate controlling shareholder of Migdal is Mr. Shlomo Eliyahu. The address of Migdal is Efal 4, Petach Tikva, Israel.
|
(2) |
Consists of 8,054,314 Ordinary Shares beneficially owned by Harel Insurance Investments & Financial Services Ltd. (“Harel”)
and entities under its control. Harel is a public company with shares traded on the TASE. To the Company's knowledge, the ultimate controlling shareholders of Harel are Mr. Yair Hamburger, Mr. Gideon Hamburger and Ms. Nurit Manor. The address
of Harel is Abba Hillel 3, Ramat Gan, Israel.
|
(3) |
Consists of 6,329,326 Ordinary Shares beneficially owned by Altshuler Shaham Ltd. (“Altshuler”) and entities under its
control. To the Company's knowledge, the ultimate controlling shareholders of Altshuler are Messrs. Gilad Altshuler and Kalman Shaham, through companies owned by them. Altshuler’s address is 21 Habarzel Street, Lobby B, Ramat Hachayal,
Tel-Aviv Israel.
|
(4) |
Consists of 10,130,711 Ordinary Shares and each beneficially owned by the Phoenix Holdings Ltd. (“Phoenix”) and entitles
under its control. Phoenix is a public company with shares traded on the TASE. To the Company's knowledge, the ultimate controlling shareholders of Phoenix, through their control in Belanus Lux S.a.r.l (an entity incorporated under the laws
of Luxemburg), are Mr. Matthew Botein, CCP III Cayman GP Ltd. and Mr. Lewis (Lee) Sachs. The address of Phoenix is Hashalom Rd. 53, Givatayim, Israel.
|
(5) |
Consists of 10,995,722 Ordinary Shares and owned by Meitav Dash Investments Ltd. (“Meitav”) and entitles under its
control. Meitav is a public company with shares traded on the TASE. To the Company's knowledge, the ultimate controlling shareholders of Meitav are Mr. Eli Barkat, through his holdings in BRM Finance Ltd., a company incorporated in Israel,
and Mr. Avner Stepak, who holds Ordinary Shares directly and through Maya Holdings (Yeelim) Ltd., a company incorporated in Israel. The address for Meitav is 30 Darech Sheshet Haim St., Bnei Brak, Israel.
|
(6) |
Consists of 6,037,560 Ordinary Shares and owned by Clal Investments Ltd. and entitles under its control. Clal is a public company with shares traded on the
TASE.
|
(7) |
Consists of 6,015,530 Ordinary Shares and owned by Menora Mivtachim Holdings Ltd. and entitles under its control. Menora is a public company with shares traded
on the TASE.
|
(8) |
Consists of (i) 796,198 Ordinary Shares beneficially owned directly by Mr. Yavetz and (ii) 1,109,272 Ordinary Shares subject to options held by Mr. Yavetz that
are exercisable within 60 days of November 13, 2023.
|
(9) |
Consists of (i) 1,400 Ordinary Shares beneficially owned directly by Mr. Yehuda and (ii) 317,639 Ordinary Shares subject to options held by Mr. Yehuda that are
exercisable within 60 days of November 13, 2023.
|
(10) |
Consists of (i) 765,468 Ordinary Shares beneficially owned directly by Mr. Paz and (ii) 813,250 Ordinary Shares subject to options held by Mr. Paz that are
exercisable within 60 days of November 13, 2023.
|
(11) |
Consists of 250,931 Ordinary Shares subject to options held by Mr. Goren that are exercisable within 60 days of November 13, 2023.
|
(12) |
Consists of 88,438 Ordinary Shares subject to options held by Mr. Avidan that are exercisable within 60 days of November 13, 2023.
|
(13) |
Consists of 347,375 Ordinary Shares subject to options held by Mr. Seroussi that are exercisable within 60 days of November 13, 2023.
|
(14) |
Consists of 40,552 Ordinary Shares beneficially owned directly by Dr. Weil. Not included as beneficially owned by Dr. Weil are 807,604 Ordinary Shares owned
directly by Givon Investments Partnership (GAAS), which is controlled by the Weil family of which Dr. Weil is a part.
|
|
Year Ended December 31,
|
|||||||
|
2022
|
2021
|
||||||
|
(in thousands)
|
|||||||
Audit Fees(1)
|
$
|
615
|
$
|
709
|
||||
Tax Fees(2)
|
29
|
30
|
||||||
Total
|
$
|
644
|
$
|
739
|
(1) |
Audit fees for the years ended December 31, 2022 and 2021 consisted of fees for professional services provided in connection with the audit of the Company’s
annual consolidated financial statements, fees for professional services provided in connection with the Company’s registration statement for the US IPO and audit services that are normally provided by an independent registered public
accounting firm in connection with statutory and regulatory filings or engagements for those years.
|
(2) |
Tax fees for the years ended December 31, 2022 and 2021 refer to professional services rendered by the Company’s auditors, which include ongoing tax advisory,
tax compliance and tax consulting associated with transfer pricing.
|
Name
|
Age
|
Position
|
Gilad Yavetz
|
52
|
Director and Chief Executive Officer
|
Yair Seroussi
|
68
|
Chairman of the Board
|
Liat Benyamini
|
46
|
Director
|
Michal Tzuk
|
47
|
Director
|
Alla Felder
|
50
|
Director
|
Dr. Shai Weil
|
54
|
Director
|
Yitzhak Betzalel
|
57
|
Director
|
Zvi Furman
|
75
|
Director
|
a. |
Mr. Gilad Yavetz;
|
b. |
Mr. Yair Seroussi;
|
c. |
Ms. Liat Benyamini;
|
d. |
Ms. Michal Tzuk;
|
e. |
Ms. Alla Felder;
|
f. |
Dr. Shai Weil;
|
g. |
Mr. Yitzhak Betzalel; and
|
h. |
Mr. Zvi Furman.”
|
|
|
ENLIGHT RENEWABLE ENERGY LTD.
13 AMAL ST., AFEK INDUSTRIAL PARK
ROSH HA’AYIN 4809249, ISRAEL
|
VOTE BY INTERNET - www.proxyvote.com or scan the QR Barcode above
Use the Internet to transmit your voting instructions and for electronic delivery of information up until 11:59 p.m. Eastern Time the day before the cut-off date
or meeting date. Have your proxy card in hand when you access the web site and follow the instructions to obtain your records and to create an electronic voting instruction form.
|
ELECTRONIC DELIVERY OF FUTURE PROXY MATERIALS
If you would like to reduce the costs incurred by our company in mailing proxy materials, you can consent to receiving all future proxy statements, proxy cards and
annual reports electronically via e-mail or the Internet. To sign up for electronic delivery, please follow the instructions above to vote using the Internet and, when prompted, indicate that you agree to receive or access proxy materials
electronically in future years.
|
|
VOTE BY PHONE - 1-800-690-6903
Use any touch-tone telephone to transmit your voting instructions up until 11:59 p.m. Eastern Time the day before the cut-off date or meeting date. Have your proxy
card in hand when you call and then follow the instructions.
|
|
VOTE BY PHONE - 1-800-690-6903
Use any touch-tone telephone to transmit your voting instructions up until 11:59 p.m. Eastern Time the day before the cut-off date or meeting date. Have your proxy
card in hand when you call and then follow the instructions.
|
V26021-P00927 KEEP THIS
PORTION FOR YOUR RECORDS
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DETACH AND RETURN THIS PORTION ONLY
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The Board of Directors recommends you vote FOR the following proposals:
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For |
Against |
Abstain
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For
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Against
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Abstain
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|
1. |
Approve the
re-appointment of Somekh Chaikin, a member firm of KPMG International, as the Company’s independent registered
public accounting firm for the year ending December 31, 2023, and until the next annual general meeting of shareholders, and to authorize the Company’s Board of Directors, following the approval of the Audit Committee, to approve
and ratify the remuneration of such firm in accordance with the volume and nature of their services.
|
☐ |
☐
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☐
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|||||
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2d. |
Ms. Michal Tzuk
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☐
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☐
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☐
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2e. |
Ms. Alla Felder
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☐
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☐
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☐
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2f. |
Dr. Shai Weil
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☐
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☐
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☐
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|
||||||
2g. |
Mr. Yitzhak Betzalel
|
☐ | ☐ | ☐ | ||||||||||||||||
|
2. |
Elect each of
the following nominees to the Board of Directors of the Company, to hold office until close of the Company’s
annual general meeting to be held in 2024, and until his or her successor has been duly elected or appointed, or until his or her office has been vacated pursuant to any applicable law or the Articles of Association:
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2h.
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Mr. Zvi Furman
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NOTE: Such other business as may properly come before the meeting or any adjournment thereof.
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Nominees:
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2a. |
Mr. Gilad Yavetz
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2b. |
Mr. Yair Seroussi
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2c. |
Ms. Liat Benyamini
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Please sign exactly as your name(s) appear(s) hereon. When signing as
attorney, executor, administrator, or other fiduciary, please give full title as such. Joint owners should each sign personally. All holders must sign. If a corporation or partnership, please sign in full corporate or partnership
name by authorized officer.
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Signature [PLEASE SIGN WITHIN BOX]
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Date
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Signature (Joint Owners)
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Date
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