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PROXY ACCESS REVOCATION FORM Please complete this authorization only if you would like to revoke your proxies access to your health information through My Frisbee Connect. Please bring completed form

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What is proxy access revocation form?

Proxy access revocation form is a document that allows shareholders to revoke their authorization for another individual or entity to act as their proxy in voting on corporate matters.

Who is required to fill out proxy access revocation form?

Shareholders who have previously granted proxy access to another party and wish to revoke that authorization are required to fill out the proxy access revocation form.

How to fill out proxy access revocation form?

To fill out the proxy access revocation form, shareholders must provide their identifying information, specify the proxy access authorization being revoked, and submit the form to the appropriate entity.

What is the purpose of proxy access revocation form?

The purpose of the proxy access revocation form is to allow shareholders to retract their authorization for a proxy to vote on their behalf in corporate matters.

What information must be reported on proxy access revocation form?

The proxy access revocation form must include the shareholder's identifying information, details of the proxy access authorization being revoked, and any other relevant information requested on the form.

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