I appoint ______________________as my proxy to vote all of my shares of stock of _______________________[JV2], a ____________________________[JV3] corporation doing business as _________________________[JV4], at the regular meeting of shareholders to be held on _________________________2004[JV5].
Dated: _________________________________________________________________
By: _________________________________________________________________
Address of Shareholder:
[JV1]This form is distributed to shareholders who will not be able to attend a regularly scheduled shareholders meeting. This is the form with which a shareholder grants another the right to vote on his/her behalf. There are rules governing when the form is to be submitted and to whom.
[JV2]Company name
[JV3]State in which company is registered
[JV4]If your company does business under a different name, refer to that company here, otherwise, just fll in the company name
[JV5]Make sure you fill in the correct year!