Director's Proxy

Director's Proxy


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__________________________, a director of ____________________, herewith appoints and designates as his/her proxy __________________, for a meeting of the board of directors scheduled for ___________________, with the full right and authority to vote in the place of ____________________, provided, however, that there is no right of substitution.  Therefore, for attendance and quorum purposes, I should be counted as in attendance.





Dated: ______________________



Notary's Acknowledgment

State of:

County of:


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