Cos Targoviste S A : Correspondence Voting Form for AOGSM 28(29).04.2021

CORRESPONDENCE VOTING FORM

COS TARGOVISTE S.A.

(în reorganizare judiciară, in judicial reorganisation, en redressement)

which is to be held on 28.04.2021, starting with 11.00 o'clock am (or 29.04.2021, starting with 11.00 o'clock am , second convened session) at office headquarters located in

Târgovişte, Şoseaua Găeşti nr.9-11, jud. Dâmboviţa

I/The undersigned: _______________________________________________

domiciled / headquartered in: city________________________street________________________ ,

no____ building___ floor ____ county ______________, country _______________

registered with ________________ under number ______________, sole registration code___________,

represented by Mr. ________________________, in quality of ______________________, identified

with Identity Card/Passport/Residence Permit series _____no _____________issued by

_____________on _______________ personal identification number__________________ (Fill in case of shareholder - legal person)

identified with Identity Card/Passport/Residence Permit series ______no _________issued by

________________at _______________ personal identification number__________________ (Fill in case of shareholder - natural person)

As a shareholder of COS TARGOVISTE S.A. (în reorganizare judiciară, in judicial reorganisation, en redressement), holder of a number of _________________shares on the reference day (15.04.2021), what awards me/us _________________ number of voting rights in the Ordinary General Meeting of Shareholders of COS TARGOVISTE S.A. (în reorganizare judiciară, in judicial reorganisation, en redressement), which is convened on 28.04.2021, starting with 11.00 o'clock am (or 29.04.2021, starting with 11.00 o'clock am, second convened session) at office headquarters located in Romania, Târgovişte, Şoseaua Găeşti nr.9-11, jud. Dâmboviţa, hereby submit herein

CORRESPONDENCE VOTING FORM

Item 1 of the Agenda: Approval of company financial statements for the financial year of 2020 based on the Reports showed by the Special Administrator and Financial Auditor.

FOR	AGAINST	ABSTENTION

Item 2 of Agenda: Approval of the proposal to cover the accounting loss related to the financial year 2020 from the accounting profits related to the future financial years.

FOR	AGAINST	ABSTENTION

Item 3 of Agenda: Appointment of the financial auditor, considering the expiration of the mandate of the financial auditor BDO AUDIT SRL, with the proposal to be appointed company PROF CONSULT SRL, having its headquarters in Gaesti, fiscal code 13821318, financial auditor, memberof the Romanian Chamber of Financial Auditors (CAFR) with authorization number 183/04.04.2002, legally represented by Mrs. Buta Marijana, financial auditor, CAFR member with certificate number 513/19.09.2000 for a mandate valid until 29.04.2022.

Auditor

FOR

AGAINST

ABSTENTIONSecret ballot, expressed in a closed envelope attached to this form

Item 4 of Agenda: Approval of the remuneration policy for the administrative and executive management of the company in accordance with the provisions of art. 92 index 1 of Law 24/2017.

FOR	AGAINST	ABSTENTION

Item 5 of the Agenda : Approval of registration date as per art. 86 (1) of the Law no. 24/2017 and "ex date" as per art. 2, alin. (2), let. l) of ASF Regulation no. 5/2018. Proposition for registration date: 27.05.2021. Proposition for ,,ex date": 26.05.2021.

FOR	AGAINST	ABSTENTION

This Correspondence Voting Form shall be laid down until 26.04.2021, 11:00 o'clock am, at the COS TÂRGOVIŞTE S.A. (în reorganizare judiciară, in judicial reorganisation, en redressement) headquarters located in Targoviste, 9-11 Gaesti street, Dambovita, Romania, or transmitted in the same term by e-mail to the [e-mail] extended electronic signature, according to the provisions of Law no. 455/2001 regarding the electronic signature, under sanction of losing the right to exercise the voting right in the general meeting by representative, pursuant to the provisions of law.

Do hereby enclose:

• i) a copy of the valid identification document (identity card/Passport/Residence Permit);

• ii) Finding Certificate issued by the Trade Registry, not older than 3 months, or any other proof issued by a competent authority regarding the identity of the legal representative of the shareholder- legal person; iii) Telephone number for contact _________________

Signature of shareholder natural person or of the legal representative of the shareholder legal person ______________________________________________________________

(Fill the name of shareholder natural person or shareholder's name and the name of the legal representative of a legal person clearly and completely)

______________________________

(Signature)

______________________________

(Stamp - for legal person)

Date: __________________

ANNEX AT CORRESPONDENCE VOTING FORM

COS TARGOVISTE S.A. (în reorganizare judiciară, in judicial reorganisation, en redressement), which is to be held on 28.04.2021, starting with 11.00 o'clock am (or 29.04.2021, starting with 11.00 o'clock am, second convened session) at office headquarters located in Romania, Târgovişte, Şoseaua

Găeşti nr.9-11, jud. Dâmboviţa

I/The undersigned: _______________________________________________

domiciled / headquartered in: city________________________street________________________ , no____ building___ floor ____ county ______________, country _______________

registered with code___________,________________ undernumber ______________, sole registrationrepresented by Mr. ________________________, in quality of ______________________, identified

with Identity Card/Passport/Residence Permit series _____no _____________issued by

_____________on _______________ personal identification number__________________ (to be filled in case of shareholder - legal person)

identified with Identity Card/Passport/Residence Permit series ______no _________issued by

________________on _______________ personal identification number__________________ (to be filled in case of shareholder - natural person)

We express our secret ballot on Item 3 on the agenda of the Ordinary General Meeting of

Shareholders of COS TARGOVISTE S.A. (în reorganizare judiciară, in judicial reorganisation, en redressement), which is to be held on 28.04.2021, starting with 11.00 o'clock am (or 29.04.2021, starting with 11.00 o'clock am, second convened session) at office headquarters located in Romania, Târgovişte, Şoseaua Găeşti nr.9-11, jud. Dâmboviţa, as follows:

Item 3 of the Agenda : Appointment of the financial auditor, considering the expiration of the mandate of the financial auditor BDO AUDIT SRL, with the proposal to be appointed company PROF CONSULT SRL, having its headquarters in Gaesti, fiscal code 13821318, financial auditor, member of the Romanian Chamber of Financial Auditors (CAFR) with authorization number 183/04.04.2002, legally represented by Mrs. Buta Marijana, financial auditor, CAFR member with certificate number 513/19.09.2000 for a mandate valid until 29.04.2022.

Auditor	FOR	AGAINST	ABSTENTION
PROF CONSULT SRL

Signature of natural person shareholder, or of the legal representative of the shareholder legal person.

______________________________________________________________

(Fill the name of shareholder natural person or shareholder legal person and the name of the legal representative of a legal person, clearly and completely)

______________________________

(Signature)

______________________________

(Stamp - for legal person)

Date : __________________