PVA TePla : Power of attorney to a third party

General Meeting of PVA TePla AG on 26 June 2024

Proxy to a third person

			Name / company
Ticket number:		name:
Number of shares:		First name:
Phone number:*			Email address:*

* voluntary information

To be returned to:

PVA TePla AG	Email:	[e-mail]
c/o Better Orange IR & HV AG
Haidelweg 48
81241 Munich
Germany

Note: Please explicitly inform your proxy about the explanations on data protection and the disclosure of personal data.

I/We herewith authorize, if applicable under revoking a prior granted proxy,

First name of proxy *

Last name or company name of proxy *

Street of proxy **

No **

Country **

ZIP Code **

Place of residence or seat of proxy *

Email of proxy **

*  Mandatory fields

to represent me/us with disclosure of my/our name at the general meeting of PVA TePla AG on 26 June 2024 and to exercise the shareholder rights, in particular the voting right. This proxy includes the right to grant a sub-proxy.

• Recommended data, cf. following note: After receipt of the proxy or the proof of proxy, individual access data to the password- protected internet service will be created for the proxy. These will be sent directly to the proxy if the address details of the proxy are complete. If the address details of the proxy are incomplete, the individual access data of the proxy to the password-protected internet service shall be transmitted to the grantor of proxy for forwarding to the proxy.

__________________________	____________________	_______________________________________________________
Place	Date	Signature(s) or other indication of completion (e.g. name / company
		name of the declaring person(s))