"
. Name of Company
I/We
..of
in the district of,
.being a
member/members of above named company hereby appoint
.of
in the
district of
or failing him
..of
. in the district
of
.as
..my/our Proxy to vote for me /us on my/our behalf at the
annual general meeting / general meeting (not being an annual general meeting)
of the company to be held on the
..day of
and at any adjournment
thereof.
Signed this
day of
..20
."
"
.Name of Company
I/We
. .of
in the district of
..,
being a member/members of the above named company, hereby appoint,
.
in the district of
or failing him
..of
. in the
district of
., as my/our Proxy to vote for me /us on my/our behalf at
the annual general meeting/general meeting (not being an annual general
meeting) of the company to be held on the
.. day of
20
and at any
adjournment thereof
