Proxy Voting Authorization Form

Proxy Voting Authorization Form

I, _______________________, in my role as {position}, hereby authorize ______________________ to act as my proxy and vote on my behalf {at meeting, in board election, etc.}.

DURATION

This proxy shall be in effect from {date} to {date}. This person is now empowered to cast my vote on {all matters/specific matter} brought before the {body} at the scheduled meeting of {date}. It shall not be valid for any subsequent meetings or votes.

INSTRUCTIONS

The proxy shall cast the vote {based on their own judgement of my best interests, or in a specific manner dictated by me beforehand}. I fully trust my proxy in this regard.

REVOCATION

This Proxy Voting Authorization can be revoked by either party, up to the time of the meeting. If I become able to attend the meeting and represent myself, I shall immediately regain my voting authority and revoke the proxy’s authority.

RULES

This proxy is being designated as allowed by {bylaws, government ordinance, etc.}.

____________________________________

Party 1 signature & date

____________________________________

Proxy signature & date

Index of Printable Contract Examples