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My Chart Patient Portal Proxy Access Request and Authorization Patient Information: Patient Name: ___ Last First M.I.___ Date of BirthAddress: ___ Street Address City State Zip Code___ Email AddressPatient/Parent:

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How to fill out proxy access request and

01

Obtain a proxy access form from the company website or shareholder services department.

02

Fill out the form with your personal information, including your name, address, and number of shares owned.

03

Sign and date the form to certify that the information provided is accurate.

04

Submit the completed form according to the instructions provided, either by mail, fax, or email.

05

Wait for a confirmation of your proxy access request from the company.

Who needs proxy access request and?

01

Shareholders who are unable to attend a company's annual meeting in person.

02

Shareholders who wish to authorize someone else to vote on their behalf at the annual meeting.

03

Shareholders who want to have a say in important company decisions but cannot physically be present.

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What is proxy access request and?

Proxy access request is a right for shareholders to include their own nominees for the board of directors in a company's proxy materials.

Who is required to file proxy access request and?

Shareholders who meet certain ownership requirements are eligible to file a proxy access request.

How to fill out proxy access request and?

Shareholders can fill out a proxy access request by following the guidelines set forth by the company in their proxy statement.

What is the purpose of proxy access request and?

The purpose of proxy access request is to give shareholders more influence in the election of the board of directors.

What information must be reported on proxy access request and?

Proxy access requests must include information about the nominee being proposed for the board.

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