Proxy Appointment

"*" indicates required fields

Date*

Name*

Address*

Street Address Address Line 2 City State Postcode

Deposited Plan No.*

First Appointee's Name*

First Appointee's Address*

Street Address Address Line 2 City State Postcode

Second Appointee's Name

Second Appointee's Address

Street Address Address Line 2 City State Postcode

Period or number of meetings for which appointment of proxy has effect:*

(Note: The appointment cannot have effect for more than 12 months or 2 consecutive annual general meetings, whichever is the greater.)

Custom Duration

Duration Type

Voting Matters

Matters and Limitations

If a vote is taken on whether (the managing agent) should be appointed or remain in office or whether another managing agent is to be appointed, I/we want the proxy to vote as follows

Request an Appointment