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Proxy Access Request and Authorization Form 1. Patient Information: Patient Name: Date of Birth: Last First M. I Address: Medical Record Number: Street Address City, State Zip Code (Optional)2. Proxy

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What is proxy access request and?

Proxy access request allows eligible shareholders to nominate candidates for the company's board of directors using the company's proxy materials.

Who is required to file proxy access request and?

Shareholders who meet certain eligibility criteria are required to file proxy access requests.

How to fill out proxy access request and?

Proxy access requests can be filled out and submitted to the company's corporate secretary in accordance with the company's bylaws and proxy access guidelines.

What is the purpose of proxy access request and?

The purpose of proxy access request is to give eligible shareholders the opportunity to nominate candidates for the company's board of directors and have them included in the company's proxy materials.

What information must be reported on proxy access request and?

Proxy access requests must include information about the nominee(s), the nominating shareholder(s), and other required disclosures as specified in the company's proxy access guidelines.

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