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Proxy Appointment
"
*
" indicates required fields
Date
*
DD slash MM slash YYYY
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State
Postcode
Deposited Plan No.
*
First Appointee's Name
*
First
Last
First Appointee's Address
*
Street Address
Address Line 2
City
State
Postcode
Second Appointee's Name
First
Last
Second Appointee's Address
Street Address
Address Line 2
City
State
Postcode
Period or number of meetings for which appointment of proxy has effect:
*
1 meeting
1 month
12 months
2 consecutive agm
Other
(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
Meetings
Months
Voting Matters
This form authorises the proxy to vote on my/our behalf on all matters.
This form authorises the proxy to vote on my/our behalf on the following matters only
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
Consent
I understand that, if the proxy already holds more than the maximum number of proxies allowed, the proxy will not be permitted to vote on my/our behalf on any matters.
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