REVOCABLE PROXY
For payment of one dollar ($1) and other compensation, I hereby confer upon ________ _____________________________ a proxy to vote ________________ ( ___ ) shares of _____________________ (hereinafter "Corporation") in my stead and on my behalf at the Corporation shareholders' meeting to be held on _____________________, and at all subsequent regular and special meetings of shareholders of the Corporation. Said person shall have all the power to vote and attend meetings as I currently enjoy. Until this proxy is revoked, which act may be executed without notice, I shall not vote the shares represented.
_______________________________ Signed
________________ Date