______(For Legal Entities: Position)

SHAREHOLDER'S REQUEST TO WITHDRAW OFFER FOR THE SALE TO "BANK "SAINT-PETERSBURG" PUBLIC JOINT STOCK COMPANY OF ORDINARY REGISTERED SHARES OF PJSC "BANK "SAINT-PETERSBURG" (hereinafter, "the Bank") IN BOOK-ENTRY FORM No. ______DATED ______, 2016

1. / Full name (full company name) of the shareholder.
2. / ID details (series, number, date of issue, issuing authority) – for individual shareholders
Legal entity registration details:
- for Russian legal entities: date, registration number, registering authority/entry made in the Unified State Register of Legal Entities (Principal State Registration Number – OGRN, date, registering authority);
- for non-resident legal entities:
Registering authority, registration number, date and place of registration
3. / Place of residence (for individuals), place of business (for legal entities)
I HEREBY WITHDRAW MY OFFER FOR THE SALE TO "BANK "SAINT-PETERSBURG" PUBLIC JOINT STOCK COMPANY OF ORDINARY REGISTERED SHARES OF PJSC "BANK "SAINT-PETERSBURG" IN BOOK-ENTRY FORM (hereinafter, "the Shares") PREVIOUSLY SUBMITTED TO THE BANK
4. / Number of shares that the party submitting this Request wished to sell to the Bank / ______(______
______) shares
(in figures and words)
Signature and full name (for individuals)
Signature, full name and position (for legal entities) / ______(full name)

______(for legal entities: position)

Signature Seal
5. / Details of the Power of Attorney (if the Request is signed by a representative of an individual/legal entity acting on the basis of Power of Attorney)
6. / Date

NOTARY'S OR BANK'S

CERTIFICATION OF SIGNATURE (for individuals):

------

FOR THE BANK'S USE ONLY

RECEIVED BY/ON:

(full name, date, signature):

* Note to the shareholder: if the Request is signed by a representative of the shareholder, it must be accompanied by a Power of Attorney. The Request for withdrawal of the shareholder's Offer must be printed on both sides of the paper. Otherwise the pages must be stitched together and numbered.