Luxottica Group, S.p.A. (LUX)

1.     DECLARATION OF THE REGISTERED OWNER OF THE DIVIDENDS

The undersigned,                          (name of the Beneficial Owner), resident in                          and beneficial Owner of the dividends on the equities listed below, all registered in its name or in the name of                          (the Custodian) and deposited with Monte Titoli Milano.

Is fully responsible for formally declaring that:

•

It does not carry on any trade or business in Italy trough a permanent establishment within the meaning of the art. 5 of the Double Taxation Agreement between Italy and                          (country of residence of the Beneficial Owner);



•

It is resident in                          with the meaning of the art. 5 of the aforementioned Double Taxation Agreement between Italy and                          (country of residence of the Beneficial Owner); and



•

By virtue of art. 10 of the Double Taxation Agreement, it request partial refund of Italian SUBSTITUTE TAX on the dividends, amounting to Euro                           

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1.     DECLARATION OF THE REGISTERED OWNER OF THE DIVIDENDS

The undersigned,                          (name of the Beneficial Owner), resident in                          and beneficial Owner of the dividends on the equities listed below, all registered in its name or in the name of                          (the Custodian) and deposited with Monte Titoli Milano.

Is fully responsible for formally declaring that:

•

It does not carry on any trade or business in Italy trough a permanent establishment within the meaning of the art. 5 of the Double Taxation Agreement between Italy and                          (country of residence of the Beneficial Owner);



•

It is resident in                          with the meaning of the art. 5 of the aforementioned Double Taxation Agreement between Italy and                          (country of residence of the Beneficial Owner); and



•

By virtue of art. 10 of the Double Taxation Agreement, it request partial refund of Italian SUBSTITUTE TAX on the dividends, amounting to Euro                           

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