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Proxy

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Enter the registered name of the corporation that will be holding the meeting.

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Proxy


KNOW ALL MEN BY THESE PRESENTS:


That the undersigned, a stockholder of ________ (the "Corporation") hereby nominates, constitutes, and appoints


________


as proxy to the undersigned to represent the undersigned and to vote all shares registered in the name of the undersigned in the Stock and Transfer Book of the Corporation for all matters taken up at the annual meeting of the stockholders of the Corporation to be held at the ________ on ________ at ________ and at any adjournments or postponements thereof, as fully and for all intents and purposes as the undersigned might or could do if present and acting in person.


5588 25252 5282228 525 8522582528 522 2528825882 25285225 25252 25 2525828 525 85588 82228252 52288 8585 2822 58 252 8522 88 5282225 525 882555582 852 85588 222 52282 82 828252828 8525282 252 52525882225 2258225882 5222258 252 2222822. This proxy shall be valid only for the purpose of the annual meeting of the stockholders on ________ and of any adjournments or postponements thereof.


IN WITNESS WHEREOF, the undersigned executed this proxy this ________ at ________.



________

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Proxy


KNOW ALL MEN BY THESE PRESENTS:


That the undersigned, a stockholder of ________ (the "Corporation") hereby nominates, constitutes, and appoints


________


as proxy to the undersigned to represent the undersigned and to vote all shares registered in the name of the undersigned in the Stock and Transfer Book of the Corporation for all matters taken up at the annual meeting of the stockholders of the Corporation to be held at the ________ on ________ at ________ and at any adjournments or postponements thereof, as fully and for all intents and purposes as the undersigned might or could do if present and acting in person.


5588 25252 5282228 525 8522582528 522 2528825882 25285225 25252 25 2525828 525 85588 82228252 52288 8585 2822 58 252 8522 88 5282225 525 882555582 852 85588 222 52282 82 828252828 8525282 252 52525882225 2258225882 5222258 252 2222822. This proxy shall be valid only for the purpose of the annual meeting of the stockholders on ________ and of any adjournments or postponements thereof.


IN WITNESS WHEREOF, the undersigned executed this proxy this ________ at ________.



________