Exhibit 99.4
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Holder Account Number
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Form of Proxy - Annual General Meeting to be held on December 6, 2023
Form of Proxy - Annual General Meeting to be held on December 6, 2023 This Form of Proxy is solicited by and on
behalf of Management.
Notes to proxy
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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 Management Nominees whose names are printed herein, please insert the name of your chosen proxyholder in the space provided (see reverse).
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| 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 may be required to provide documentation evidencing your power to sign this proxy with signing capacity stated.
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This proxy should be signed in the exact manner as the name(s) appear(s) on the proxy.
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If a date is not inserted in the space provided on the reverse of this proxy, it will be deemed to bear the date on which it was mailed to the holder by Management.
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The securities represented by this proxy will be voted as directed by the holder, however, if such a direction is not made in respect of any matter, and the proxy appoints the Management Nominees listed on the
reverse, this proxy will be voted as recommended by Management.
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| 6. |
The securities represented by this proxy will be voted in favour, or withheld from voting, or voted against each of the matters described herein, as applicable, in accordance with the instructions of the holder, on any ballot that may be
called for. If you have specified a choice with respect to any matter to be acted on, the securities will be voted accordingly.
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| 7. |
This proxy confers discretionary authority in respect of amendments or variations to matters identified in the Notice of Meeting and Management Information Circular or other matters that may properly come before the meeting or any
adjournment or postponement thereof, unless prohibited by law.
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| 8. |
This proxy should be read in conjunction with the accompanying documentation provided by Management.
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Proxies submitted must be received by 10:00 a.m., Toronto Time on December 4, 2023.
If you vote by telephone or 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 one of the two voting methods outlined above to vote this proxy.
To vote by telephone or the Internet, you will need to provide your CONTROL NUMBER listed below.
CONTROL NUMBER
Appointment of Proxyholder
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I/We being holder(s) of securities of IM Cannabis Corp. (the “Company”) hereby appoint: Oren Shuster, Chief Executive Officer and Director, or failing this person,
Shimmy Posen, legal counsel to the Company, or failing this person, Adam Fishman, legal counsel to the Company (the "Management Nominees")
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OR
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Print the name of the person you are appointing if this person is someone other than the Management Nominees listed herein.
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as my/our proxyholder with full power of substitution and to attend, act and to vote for and on behalf of the holder in accordance with the following direction (or if no
directions have been given, as the proxyholder sees fit) and on all other matters that may properly come before the Annual General Meeting of shareholders of the Company to be held at the offices of Garfinkle Biderman LLP, located at 1 Adelaide
Street East, Suite 801, Toronto, Ontario M5C 2V9, on December 6, 2023 at 10:00 a.m. (Toronto Time) and at any adjournment or postponement thereof.
VOTING RECOMMENDATIONS ARE INDICATED BY HIGHLIGHTED TEXT OVER THE BOXES
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1. Number of Directors
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To set the number of Directors at five.
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For | Withhold | For |
Withhold | For | Withhold |
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2. Election of Directors
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01. Oren Shuster
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02. Brian Schinderle
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03. Marc Lustig | ☐ | ☐ |
| 04. Einat Zakariya |
☐ | ☐ | 05. Moti Marcus | ☐ | ☐ | |
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Withhold | ||
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3. Appointment of Auditors
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Appointment of Kost Forer Gabbay & Kasierer, a Member of Ernst & Young Global as Auditors of the Company for the ensuing year and authorizing the Directors to fix their remuneration.
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Signature of Proxyholder
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Signature(s)
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I/We authorize you to act in accordance with my/our instructions set out above. I/We hereby revoke any proxy previously given with respect to the Meeting. If no voting instructions are indicated above, and the proxy appoints the Management Nominees, this Proxy will be voted as recommended by Management.
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Interim Financial Statements - Mark this box if you would like to receive Interim Financial Statements and accompanying Management’s Discussion
and Analysis by mail.
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Annual Financial Statements - Mark this box if you would like to receive the Annual Financial Statements and accompanying Management’s Discussion and Analysis by
mail.
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If you are not mailing back your proxy, you may register online to receive the above financial report(s) by mail at www.computershare.com/mailinglist.