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Form of Proxy

IONIS PHARMACEUTICALS, INC.

Notes

No. Proposition For Against Abstain
1

Election of Director: Allene M. Diaz

2

Election of Director: Michael Hayden

3

Election of Director: Joseph Klein, III

4

Election of Director: Joseph Loscalzo

5

To make an advisory vote on executive compensation.

6

To approve an amendment of the Ionis Pharmaceuticals, Inc. 2011 Equity Incentive Plan to increase the aggregate number of shares of common stock authorized for issuance under such plan by 4,000,000 shares to an aggregate of 42,500,000 shares.

7

To ratify the Audit Committees selection of Ernst & Young LLP as independent auditors for the 2025 fiscal year.