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PROXY
  BE IT KNOWN, that I, ________(1)________, the undersigned Shareholder of ________
  (2)_______, a _____(3)_____ corporation, hereby constitute and appoint __________(4)
  _________ as my true and lawful attorney and agent for me and in my name, place and stead, to
  vote as my proxy at the Meeting of the Shareholders of the said corporation, to be held on
  _______(5)________ or any adjournment thereof, for the transaction of any business which may
  legally come before the meeting, and for me and in my name, to act as fully as I could do if
  personally present; and I herewith revoke any other proxy heretofore given.
  WITNESS my hand and seal this _(6)_ day of ____(7)___, ___(8)____.
  ____________(9)_________________ _____________(10)______________
  ____________(9)_________________
  NOTICE
  The information in this document is designed to provide an outline that you can follow
  when formulating business or personal plans. Due to the variances of many local, city, county
  and state laws, we recommend that you seek professional legal counseling before entering into
  any contract or agreement.