PROXY FOR ANNUAL MEETING OF SHAREHOLDERS
I certify that I am the owner of __________ shares of the ______________________ stock of ____________________________, Inc., and I hereby appoint and constitute ___________________________ proxy with full power of substitution and revocation to attend and represent me at the ___________________________, Inc. shareholders annual meeting of to be held on ______________. ________________________ may vote my shares on any question, resolution, proposition, or any other business that may come before the body upon which I would be entitled to vote if I were present. This proxy shall be considered null and void if I personally attend the above mentioned meeting.
______________________________________ Shareholder
_______________ Date