I am a member of this Association. I hereby revoke all previous proxies and appoint ___________ or, if no one is named, all members of the Board of Directors who are members of the Association to act as my proxy and vote in my place at the meeting of the members to be held on at , at , or at any adjournment of the meeting. My proxyholder shall vote as instructed on the attached "Voting Instructions."
Member's Name (PRINT): _____________________________________________
Member's Signature: _______________________________________
Address: _________________________________________________
Date: _____________
................................ Separate Detachable Page ...................................
VOTING INSTRUCTIONS TO PROXYHOLDER
I AUTHORIZE my proxy to vote as follows [SELECT ONE OPTION ONLY]:
1. ___ ABSTAIN from voting (use for quorum purposes only), or
2. ___ VOTE at proxyholder's discretion, or
3. ___ VOTE as follows (put a check mark or "X" next to no more than three (3) candidates):
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[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 by the proxygiver to the proxyholder. The proxyholder must then attend the meeting on the proxygiver's behalf to vote as directed by the proxygiver.]
Cumulative Voting. See proxy format for cumulative voting.
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