Odontoprev : AGM 03.28.2017 - Remote Voting Form

Shareholder's name

Shareholder's CNPJ or CPF

Instructions on how to cast your vote

The shareholder can opt to vote by remote voting in accordance with CVM Instruction 481, by filling the Remote Voting form presented.

For this form to be considered valid, it is indispensable:

• All fields below must be correctly completed, with legible handwriting, including name indication or corporate name of the shareholder, its correspondent CPF or CNPJ, and an e-mail for possible contact;

• All pages must be initialed;

• You, the shareholder, or your legal representative(s), as applicable, must sign at the end in accordance with the relevant legislation.

Note: the Company will not require this form to be notarized nor signed by the Consulate.

If the Fiscal Council installation be required for the fiscal year of 2017, the Shareholder whose filling is in accordance with the Law 6,404/76, article 161, in other words, the individual shareholder or minority shareholders, that jointly represent 10% (ten per cent) or more of the ordinary shares, will have the right to elect, in a separate vote, a member and a respective alternate member of the Fiscal Council and, if applicable, indicate a candidate, according to the current legislation.

Instructions of sending your form, indicating the option to send directly to the Company or transmitting instructions for completion of the form to a bookkeeping agent or to the custodian

The remote voting can be executed by the shareholders' in the following ways:

1. Vote instructions sent by their custody agents, that will disclose, within the regulatory deadline, the consolidated voting map for the Company and the market;

2. Vote instructions sent by the depositary financial institution responsible for the services regarding the Company's share custody, that will disclose, within the regulatory deadline, the consolidated voting map for the Company and the market; or

3. Remote voting form that has to be sent directly to the Company

When you opt to exercise your voting rights by form, you may choose instead to send your remote form directly to the Company, initialed and signed, as well as authenticated copy of the Necessary Documentation indicated below and in the AGM 2017 Guide, not later than 7 (seven) days before the General Meeting, i.e. by 03/28/17 inclusive (Article 21- B, ICVM 481).

Forms received by the Company thereafter will be disregarded. If you prefer, you may also digitize the form and its following documents to the e-mail below, in which case you must also mail the original form paper and the authenticated copies of the other required documents until 03/24/2017.

Required Documents:

- The shareholder must deliver documentation to prove its identity, a personal ID with a photograph of you, for individuals, or a copy of the most recent corporate documents (articles of association or incorporation, bylaws etc.) and power of attorney proving its legal right to represent the shareholder for legal entities. For investment funds, it must deliver a copy of the

fund's most recent consolidated bylaws; and a copy of the fund administrator or manager's constitutional documents,

- Depositary financial institution responsible for the services regarding the Company's share custody's documents (Article 41, Lei 6.404/76) proving its quality as shareholder.

The Company will not require documents signed abroad to be notarized nor signed by the Consulate and will not require sworn translations of documents originally written in Portuguese, English or Spanish, or documents in other languages accompanied by a translation into any of these languages.

Postal and electronic address to deliver the remote voting form, in case the shareholder decides to deliver the document directly to the Company

Odontoprev S.A. | Investor Relations Department

Avenida Marcos Penteado de Ulhôa Rodrigues, nº 939, 14th floor, 1401, Edifício Jatobá, Castelo Branco Office Park, ZIP CODE 06460-040

e-mail: ir@odontoprev.com.br

The Company will notify shareholders the receipt of the form and the required accompanying documentation, and tell whether or not they have been accepted in accordance with CVM Instruction 481/2009, as amended. The forms that has not been completely filled out or not accompanied by the required documents will be disregarded and the shareholder will be notified.

Indication of institution contracted by the Company to manage the securities, with name, postal and electronic address, telephone and contact person

BANCO BRADESCO S.A.

Cidade de Deus, s/nº, Vila Yara - São Paulo ZIP Code 06029-900 Phone: + 55 11 3684-9441

Opening hours: working days from 9am to 6pm. Contact: Mr. Hamilton Brito

E-mail: hamilton.brito@bradesco.com.br

Voting instructions for the Annual General Meeting (AGM)

Resolution

1. Exam, discuss and vote the Company's Management Report and Financial Statements regarding the fiscal year ended December 31, 2016, along with the Independent Auditors, Fiscal Council and Audit Committee's opinion.

[ ] Approve [ ] Reject [ ] Abstain

Resolution

2. Management's proposal of destination of net income, considering the interest on capital and interim dividends previously announced at the Board of Directors Meeting, on top of the mandatory dividends, in accordance with the Management Proposal, along with the complementary dividends distribution in the amount of R$ 35,462,065.26 and the retention of a portion of the net income in the amount of R$ 32,398,526.54 to constitute statutory reserve, in accordance with the capital budget.

[ ] Approve [ ] Reject [ ] Abstain

Resolution

3. To fix the annual global remuneration of the Company's Management for the fiscal year of 2017 of up to R$ 18,000,000.00, in accordance with the Management Proposal.

[ ] Approve [ ] Reject [ ] Abstain

Question

4. Do you wish to set up a Fiscal council for the fiscal year of 2017, pursuant to article 161 of

Law 6.404/76?

[ ] Yes [ ] No

Fiscal Council election, on unique slate

1. Indication of all names that compose the slate - unique slate, in accordance with the Management Proposal.

2. If one of the candidates that compose the slate leaves off in order to accommodate the election separately, pursuant to article 161, § 4º, e 240 of Law 6.404, from 1976, the correspondent votes shall be taken to the selected slate?

[ ] Approve [ ] Reject [ ] Abstain

[ ] Yes [ ] No

Resolution

7. To fix the Fiscal Council members remuneration, in accordance with the Management Proposal, equivalent to 10% of the average remuneration assigned for each Officer of the Company.

[ ] Approve [ ] Reject [ ] Abstain

Question

8. In case of a second call notice for the Annual General Meeting, the vote instructions held in this Voting Form can be considered the same for the Annual General Meeting in a second call?

[ ] Yes [ ] No [ ] Abstain