Proxy form for Fungimap AGM 2023 Proxy form for Fungimap AGM 16 May 2023 Name* First Last Date* DD slash MM slash YYYY This form should be submitted at least 24 hours prior to the meeting* I declare that I am a member of Fungimap Inc. and entitled to vote at a General Meeting of members I appoint as my proxy the chair of the 2023 AGM of Fungimap Inc , OR I appoint as my proxy a Fungimap member, named below, who will be present at the 2023 AGM of Fungimap Inc Name of Member appointed as my proxy if not the chair Δ
