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    Proxy Revocation

    Uploaded by

    bruno05

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd

    Proxy Revocation

    Uploaded by

    bruno05
    14 views1 page

    Original Title

    Proxy_Revocation.rtf

    Copyright

    © © All Rights Reserved

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    RTF, PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    14 views1 page

    Proxy Revocation

    Uploaded by

    bruno05

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    of 1

    © Copyright Envision Corporation. 2002. All rights reserved.

    Protected by the copyright laws of the United States & Canada and by international treaties. IT IS
    ILLEGAL AND STRICTLY PROHIBITED TO DISTRIBUTE, PUBLISH, OFFER FOR SALE, LICENSE OR SUBLICENSE, GIVE OR DISCLOSE TO ANY OTHER
    PARTY, THIS PRODUCT IN HARD COPY OR DIGITAL FORM. ALL OFFENDERS WILL BE SUED IN A COURT OF LAW.

    REVOCATION OF PROXY
    ©
    [COMPANY NAME]
    C
    o
    p
    y
    r
    i The undersigned, as owner of the securities of [NAME OF CORPORATION] described below, hereby
    g revokes any and all proxies and substitutions of proxies, including the proxy executed on [DATE], naming
    [NAME] as proxy, and further revokes any and all authority heretofore given to any person or persons to
    h attend meetings, vote, consent, or otherwise act on behalf of the undersigned in any manner whatsoever
    t with respect to such securities.

    E
    n Dated: [DATE]
    v
    i
    s [SIGNATURE]
    i
    o
    n [PRINTED NAME AS ON STOCK CERTIFICATE]

    C
    o
    r Securities Information:
    p Certificate No.:
    o
    r Number of Shares:
    a
    t Class of Shares:
    i
    o
    n
    .

    2
    0
    0
    2
    .

    A
    l
    l

    r
    i

    Revocation of Proxy Page 1 of 1

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