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I,
of
being a member of
hereby appoint
of
being a member of that incorporated association, as my proxy to vote for me on my behalf at the general meeting of the association (annual general meeting or special general meeting, as the case may be)
to be held on the
day of
20
*My proxy is authorised to vote in favour of/against (delete as appropriate) the resolution (insert details)
*To be inserted if required
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Note: A proxy vote may not be given to a person who is not a member of the association.
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