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PROXY FORM
1. Nomination
I, ________, the undersigned shareholder of ________ (hereinafter the "Corporation"), whose latest address as shown in the records of the Corporation is:
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and having Common Share(s) in the capital of the Corporation, hereby appoint, in my absence, ________ (the "Proxyholder"), whose address is as follows:
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and in the event ________ is unwilling or unable to act as such Proxyholder, I hereby appoint ________, whose address is as follows:
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to be my Proxyholder in order to attend and act at a meeting of the Corporation on my behalf.
2. Powers
The shareholders of the Corporation shall hold an annual meeting on ________, which shall take place at the following location:
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This Proxy is being solicited by management of the Corporation.
This Proxy grants the Proxyholder the following powers:
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For greater certainty, the Proxyholder is authorized to vote in accordance with the instructions of the undersigned shareholder where such instructions are provided, and where no such instructions are given, the Proxyholder may vote at his or her own discretion on any matter properly brought before the meeting, including any amendment or variation to matters identified in the notice of meeting and any other business that may properly come before the meeting.
3. Revocation
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This Proxy is being signed, either by written or electronic signature, pursuant to the provisions of the Canada Business Corporations Act - R.S.C., 1985, c. C-44 (or any consolidation, repeal, amendment or substitute therefor).
Executed on:
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Date
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This signed Proxy will be deposited with the Corporation (or electronically if required) or an agent thereof at the following address at a time specified in the bylaws or consistent with the aforementioned Act:
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