EX-99.3 4 ea184523ex99-3_polypidltd.htm PROXY CARD FOR THE EXTRAORDINARY GENERAL MEETING TO BE HELD ON OCTOBER 9, 2023

Exhibit 99.3

 

POLYPID LTD.

 

PROXY

 

THIS PROXY IS SOLICITED ON BEHALF OF THE BOARD OF DIRECTORS

 

The undersigned hereby appoints Mr. Tal Vilnai, Secretary and General Counsel of PolyPid Ltd. (the “Company”) and Ms. Orna Blum, Assistant Secretary and Legal Counsel of the Company, and each of them, agents and proxies of the undersigned, with full power of substitution to each of them, to represent and to vote on behalf of the undersigned all the Ordinary Shares of the Company which the undersigned is entitled to vote at the Extraordinary General Meeting of Shareholders (the “Meeting”) to be held on October 9, 2023 at 2:00 p.m. Israel time, and at any adjournments or postponements thereof, upon the following matters, which are more fully described in the Notice of Extraordinary General Meeting of Shareholders and proxy statement relating to the Meeting.

 

This Proxy, when properly executed, will be voted in the manner directed herein by the undersigned. If no direction is made with respect to any matter, this Proxy will be voted FOR such matter. Any and all proxies heretofore given by the undersigned are hereby revoked.

 

(Continued and to be signed on the reverse side)

 

 

 

 

POLYPID LTD.

EXTRAORDINARY GENERAL MEETING OF SHAREHOLDERS

 

Date of Meeting: October 9, 2023

 

PLEASE SIGN, DATE AND RETURN PROMPTLY IN THE ENCLOSED ENVELOPE. PLEASE
MARK YOUR VOTE IN BLUE OR BLACK INK AS SHOWN HERE ☒

 

1. To approve compensation to Mr. Yossi BenAmram, Company’s director, as set forth in the proxy statement.

 

  FOR AGAINST ABSTAIN

 

2. To approve an options grant to the Company’s Chief Executive Officer, Ms. Dikla Czaczkes Akselbrad, as set forth in the proxy statement.

 

 

FOR AGAINST

ABSTAIN

 

2a. Do you confirm that you are NOT a controlling shareholder of the Company and/or do NOT have a Personal Interest (as such terms are defined in the Companies Law and in the proxy statement) in Proposal No. 2?*

 

YES I/We confirm that I am/ we are NOT a controlling shareholder of the Company and/or do NOT have a Personal Interest in Proposal No. 2.

 

*If you do not indicate a response for this item 2a, your shares will not be voted for Proposal No.2.

 

         
NAME   SIGNATURE   DATE
         
         
NAME   SIGNATURE   DATE

 

Please sign exactly as your name appears on this Proxy. When shares are held jointly, each holder should sign. When signing as executor, administrator, trustee or guardian, please give full title as such. If the signed is a corporation, please sign full corporate name by duly authorized officer, giving full title as such. If signer is a partnership, please sign in partnership name by authorized person.