附录 99.3

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福尔图纳银矿有限公司 安全类别 持有人账号 委托书表格-将于 2024 年 6 月 20 日星期四举行的年度会议和特别会议。本委托书由管理层征集并代表管理层征集。 代理注意事项 1.每位持有人都有权指定自己选择的其他人或公司(不一定是持有人)出席会议或任何休会或 延期,并代表他们行事。如果您想任命除此处印有姓名的管理候选人以外的个人或公司,请在提供的空白处插入您选择的 代理持有人的姓名(见反面)。 2。如果证券以多个所有者(例如共同所有权、受托人、遗嘱执行人等)的名义注册,则所有注册者都应签署该委托书。如果您代表公司或其他个人投票 ,则可能需要提供文件,证明您有权签署该代理并注明签名能力。 3。该代理的签名方式应与代理服务器上显示的名称完全相同。 4。如果未在此委托书背面提供的空白处填写日期,则该日期将被视为管理层邮寄给持有人的日期。 5。该代理所代表的证券将按照持有人的指示进行投票,但是,如果没有就任何事项做出这样的指示,并且代理人任命了背面列出的管理层 被提名人,则该代理人将按照管理层的建议进行投票。 6。根据持有人的 指示,在可能需要的任何投票中,将对本代理所代表的证券投赞成票,或不予表决,或视情况对本文所述的每项事项投反对票。如果您已就任何要采取行动的事项指定了选择,则将对证券进行相应的投票。 7。除非法律禁止,否则本委托书授予对会议通知和管理信息通告中确定的事项的修改或变更的自由裁量权,或可能在会议或任何休会或延期之前 的其他事项。 8。该代理应与管理层提供的随附文件一起阅读。 提交的代理必须在 2024 年 6 月 18 日星期二太平洋时间上午 10:00 之前收到。 每周 7 天、每天 24 小时使用电话或互联网进行投票! 使用电话投票 • 使用按键音 电话拨打下面列出的号码。 1-866-732-VOTE (8683) 免费电话 使用互联网进行投票 • 访问以下网站: www.investorvote.com • 智能手机? 扫描二维码立即投票。 如果您通过电话或互联网投票,请勿将此代理邮寄回去。 邮寄投票可能是以公司名义持有的证券或代表他人投票的唯一方法。 通过邮寄或互联网投票是持有人可以指定某人为代理持有人的唯一方法,而不是此 代理背面指定的管理层候选人。您可以选择上面概述的两种投票方法之一来对该代理进行投票,而不是邮寄此代理。 要通过电话或互联网投票,您需要提供下面列出的控制号码。 控制号码 ------- 折叠 ------- 折叠

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------- Fold ------- Fold Appointment of Proxyholder I/We being holder(s) of securities of Fortuna Silver Mines Inc. (the “Company”) hereby appoint: Jorge Ganoza Durant, CEO, or failing him, David Laing, Chairman, or failing him, Linda Desaulniers, Corporate Counsel, or failing her, Sally Whittall, Corporate Secretary (the "Management Nominees") OR Print the name of the person you are appointing if this person is someone other than the Management Nominees listed herein. 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 and Special Meeting of shareholders of the Company to be held in the Cheakamus Room, Fairmont Waterfront Hotel, 900 Canada Place, Vancouver, British Columbia on Thursday, June 20, 2024 at 10:00 am, Pacific Time and at any adjournment or postponement thereof. VOTING RECOMMENDATIONS ARE INDICATED BY HIGHLIGHTED TEXT OVER THE BOXES. 1. Number of Directors To set the number of Directors at eight (8). For Against 2. Election of Directors 01. Jorge Ganoza Durant For Withhold 02. Mario Szotlender For Withhold 03. David Farrell For Withhold 04. David Laing 05. Alfredo Sillau 06. Kylie Dickson 07. Kate Harcourt 08. Salma Seetaroo 3. Appointment of Auditors Appointment of KPMG LLP as Auditors of the Company for the ensuing year and authorizing the Directors to fix their remuneration. For Withhold 4. Approval of Change of Name of the Company To consider, and if thought fit, pass a special resolution to approve a change in the name of the Company from “Fortuna Silver Mines Inc.” to “Fortuna Mining Corp.”. For Against Signature of Proxyholder 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. Signature(s) Date Interim Financial Statements - Mark this box if you would like to receive Interim Financial Statements and accompanying Management’s Discussion and Analysis by mail. 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. 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. F S V Q 3 6 4 0 0 1 A R 1