This Form of Proxy is solicited by and on behalf of Management.
Notes to proxy
Proxies submitted must be received by 10:00 AM, Pacific Time, on August 12, 2010.
VOTE USING THE INTERNET 24 HOURS A DAY 7 DAYS A WEEK!
To Vote Using the Internet
• Go to the following web site: www.investorvote.com
If you vote by the Internet, DO NOT mail back this proxy.
Voting by mail may be the only method for securities held in the name of a corporation or securities being voted on behalf of another individual.
Voting by mail or by Internet are the only methods by which a holder may appoint a person as proxyholder other than the Management nominees named on the
reverse of this proxy. Instead of mailing this proxy, you may choose to vote using the Internet.
To vote by the Internet, you will need to provide your CONTROL NUMBER listed below.
CONTROL NUMBER 123456789012345
FORBES MEDI-TECH INC.
9th Floor, 100 University Avenue
Toronto, Ontario M5J 2Y1
MR SAM SAMPLE
123 SAMPLES STREET
SAMPLETOWN SS X9X 9X9
Holder Account Number
X X X
Form of Proxy - Annual General and Special Meeting to be held on August 16, 2010
1. Every holder has the right to appoint some other person or company of their choice, who need not be a holder, to attend and act on their behalf at
the meeting or any adjournment or postponement thereof. If you wish to appoint a person or company other than the persons whose names are
printed herein, please insert the name of your chosen proxyholder in the space provided (see reverse).
2. If the securities are registered in the name of more than one owner (for example, joint ownership, trustees, executors, etc.), then all those registered should sign
this proxy. If you are voting on behalf of a corporation or another individual you must sign this proxy with signing capacity stated, and you may be required to
provide documentation evidencing your power to s