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PROXY UNDER SOCIETIES REGISTRATION ACT





I, AA., son of ________, of ________. being a member of this ________Society and entitled to vote do hereby appoint BB., son of ________of_________ to be my proxy to vote for me and on my behalf at the (ordinary or extraordinary, as the case may be) general meeting of the Society to be held on the ________day of ________and at any adjourned meeting thereof.

In witness whereof I have set my hand hereunto this ________day of________, 20_______

Signature

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Stamp



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