Revocable Proxy

$25.00
This is a form of revocable proxy, granting another party the right to vote shares held by the shareholder.

Format: word_icon Microsoft Word

REVOCABLE PROXY
[Name of Corporation]

The undersigned, as record holder of the securities of [name of corporation] described below, hereby revokes any previous proxies and appoints [name] as the undersigned’s proxy to attend all shareholders’ meetings and to vote, execute consents, and otherwise represent those shares in the same manner and with the same effect as if the undersigned were personally present at any such meeting or voting such securities or personally acting on any matters submitted to shareholders for approval or consent.

The proxy holder will have the full power of substitution and revocation.

This proxy is ...

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