KESM Industries : Request Form for printed copies of the Annual Report 2022 and Circular to Shareholders

KESM INDUSTRIES BERHAD

Registration No. 197201001376 (13022-A)

REQUEST FORM

Instructions: Please tick accordingly and fill in your details below. We regret that we will not be able to process request form which is incomplete or incorrectly filled. Thank you for your understanding.

Please send me/us a printed copy of the Annual Report 2022.

Please send me/us a printed copy of the Circular to Shareholders dated 27 October 2022.

Name of Shareholder (Full Name):		NRIC/Passport/Co. Regn. No.:

Contact No./Email address:		CDS Account No.:

Address:

Signature:Date:

Please submit the completed Request Form to our Share Registrar's office by mail or fax to [phone]; or email to [e-mail].

We will mail the Annual Report 2022 and/or Circular to Shareholders dated 27 October 2022 to you within four (4) market days, from the date of receipt of your request.

Note: This request is valid for the Annual Report 2022 and Circular to Shareholders dated 27 October 2022 only.

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M A L A Y S I A

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