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NELSON, INC. 9th Floor, 100 University Avenue Toronto, Ontario M5J 2Y1 www.computershare.com MR SAM SAMPLE 123 SAMPLES STREET SIMPLETON SS X9X 9 9 Security Class COMMON Holder Account Number C1234567890
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Point by point instructions on how to fill out the form of proxy:

01
Begin by carefully reading the instructions provided with the form. It is important to understand the purpose and requirements of the proxy before proceeding.
02
Start by providing your personal information in the designated spaces. This typically includes your full name, address, phone number, and email address. Ensure that the information is accurate and up to date.
03
Next, identify the person you are appointing as your proxy. This is the individual who will represent you and make decisions on your behalf. Fill in their full name, address, and contact details.
04
Specify the duration or time frame for which you are appointing the proxy. You may need to indicate a specific date or event, or you can provide a general timeframe. Make sure to include any limitations or conditions on their authority, if applicable.
05
State the specific powers or responsibilities you are delegating to your proxy. This might include voting on your behalf at a meeting, making certain decisions, or managing your affairs. Be clear and concise in outlining these powers.
06
Review the form carefully to ensure that all sections have been completed accurately and legibly. Double-check for any missing information or errors. If required, sign and date the form in the designated spaces.

Who needs this form of proxy?

01
Individuals who are unable to attend a meeting or event where their vote or representation is required. This can include individuals who are out of town, unwell, or otherwise unable to attend in person.
02
Shareholders or members of an organization who wish to delegate their voting rights to a trusted individual. This is common in corporate settings or membership-based organizations.
03
Individuals who require someone to act on their behalf due to legal or personal reasons. This might include individuals who are incapacitated, undergoing medical treatment, or temporarily absent.
Regardless of the specific situation, the form of proxy provides a legally recognized authorization for someone else to act in your best interest. It is essential to understand the form's requirements and ensure it is completed accurately.
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This form of proxy is a legal document that authorizes someone else to vote on behalf of another person during a meeting or election.
Any individual or entity who cannot attend a meeting or election in person and wants to grant voting authority to another person.
To fill out this form of proxy, you need to provide your name, the name of the person you are authorizing to vote on your behalf, the date of the meeting or election, and your signature.
The purpose of this form of proxy is to allow individuals or entities who cannot attend a meeting or election to still have their vote counted.
The information that must be reported on this form of proxy includes the names of the person granting authority and the person receiving authority, the date of the meeting or election, and the signature of the person granting authority.
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