[From: Free Document Downloads at TheSmallBusinessOwnersManual.com] This document should be used as an authorization to vote shares. The following text of this document should be reviewed and edited to fit your purposes. [Find, then fill-in, or delete text in brackets like this: “[NNN]” If there are dates in this document, they will automatically change to today’s date.
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Otherwise the following text should be reviewed and edited as needed:
AUTHORIZATION (PROXY) TO VOTE SHARES
Date: [DATE] The undersigned, the record owner of [COMPANY NAME] Corporation's Share Certificate No. [N], representing [N] shares of stock in the [COMPANY NAME] Corporation, authorizes [N] to vote the aforementioned shares at the Corporation's shareholders' meeting to be held at the following time, date and location: Time: [TIME] Date: [DATE] Location: [LOCATION] By virtue of this proxy, [N] shall have the right to vote for the election of directors and on any other business that may be raised properly at the meeting.