Appendix 3 - Form of Appointment of Proxy

Appendix 3 - Form of Appointment of Proxy

I,………………………………………………………………………………………………… (full name of applicant)

of..………………………………………………………………………………………………

(address)  
being a member of the International Alliance for Interoperability Australasia Chapter ("the IAI-AC") (name of incorporated association)

hereby appoint …….…………………………………………………………………………

(full name of proxy)

of ………………………………………………………………………………………………

(address)  
being a member of the IAI-AC, as my proxy to vote for me on my behalf of the general meeting of the IAI-AC (annual general meeting or special general meeting as the case may be) to be

held on the …………..day of ………….., 19…….. and at any adjournment of that meeting.

• My proxy is authorised to vote in favour of / against (delete as appropriate) the resolution (insert details).
• To be inserted if desired.

 
……………………………………….....
Signature of member appointing proxy
 
Date……………………………………..

NOTE: A proxy may not be given to a person who is not a member of the IAI-AC.