Free General Proxy Form 

Custom Search

 

                                                       GENERAL PROXY

 

 

                The undersigned of ______________, being a stockholder of

        ______________________ Inc., does hereby constitute and appoint

        as the lawful attorney, agent and proxy of the undersigned the

        following named person:__________________ for a period of

        ______________ from the date hereof, to represent the undersigned

        at any and all stockholders meetings of ____________________

        Inc., and at any adjournment thereof, within ____________ from the

        date hereof, to act for and in the name, place and stead of the

        undersigned on all matters and things which may be presented for

        action or consideration at such meetings, giving and granting

        unto said attorney and proxy as full power in all respects as the

        undersigned could exercise if present in person.

 

                The undersigned hereby ratifies all that his attorney and

        proxy may or shall lawfully do in voting at any such meetings, or

        at any adjournment or adjournments thereof, within the period of

        time specified, in respect of all matters, proposals and

        questions that may properly come before the stockholders for

        consideration and action.

 

 

        Dated:

 

 

        ________________________________    __________________________

        Witness