I hereby revoke all previous proxies and
appoint
<name> or, if no one is named, the Board of Directors to act as my proxy and vote in my place at the
meeting of the members
to be held on
<date> at
<time> , at
<address> ,
or at any adjournment of the meeting. My proxyholder shall vote as instructed on the attached "Voting Instructions."
Member's Signature: _______________________________________
Address: _________________________________________________
Date: _____________
.............................. Separate Detachable Page ....................................
VOTING INSTRUCTIONS
I AUTHORIZE my proxy to vote as
follows:
1. ____ ABSTAIN
from voting (use for quorum purposes only), or
2. ____ VOTE
at proxyholder's discretion, or
3. ____ VOTE
as follows:
Cumulative voting is
authorized. You may cast 3 votes in any manner you choose DO NOT cast more than 3 votes. If you
make a mistake, cross out the error and initial the change.
<name
of nominee> # of votes
<name
of nominee>
# of votes _
<name
of nominee>
# of votes
<name
of nominee> # of votes
<name
of nominee>
# of votes
<NOTE: The person designated as proxyholder must be a member of the association. In addition, proxies
cannot be mailed to the association inside ballot envelopes. They must
be delivered to the proxyholder, who must attend the meeting on the
proxygiver's behalf.>