PROXY
(Pursuant to Section 57 of the Revised Corporation Code of the Philippines, Republic Act No. 11232)
KNOW ALL MEN BY THESE PRESENTS:
That the undersigned, ________, of legal age, with residence and postal address at ________, being the registered owner and holder of ________ shares of stock standing in his/her name in the Stock and Transfer Book of ________, a corporation duly organized and existing under and by virtue of the laws of the Republic of the Philippines, with principal office at ________ (hereinafter referred to as the "Corporation"), does hereby nominate, constitute, and appoint:
________, of legal age, with residence and postal address at ________
as the true and lawful attorney-in-fact and proxy of the undersigned, with full power and authority to represent the undersigned and to vote all shares registered in the name of the undersigned in the Stock and Transfer Book of the Corporation, upon and with respect to all matters that may be taken up at the meeting of the stockholders of the Corporation, under the terms and conditions hereinafter set forth.
§ 1. Authority to Represent and Vote. The herein-named proxy is hereby authorized to attend, participate, deliberate, and vote, in person or, where permitted, through remote communication or in absentia in accordance with the Corporation's By-Laws and applicable rules of the Securities and Exchange Commission, at the ________ meeting of the stockholders of the Corporation to be held at ________ on ________ at ________, and at any and all adjournments or postponements thereof, as fully and to all intents and purposes as the undersigned might or could do if personally present and acting.
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§ 3. Duration and Validity. In accordance with Section 57 of the Revised Corporation Code of the Philippines, this proxy shall be valid only for the meeting for which it is intended unless otherwise provided herein, and shall not be valid and effective for a period longer than five (5) years at any one time. Accordingly, this proxy shall be valid for the meeting specified in § 1 hereof and for any adjournments or postponements thereof, and shall otherwise remain effective until ________, unless sooner revoked.
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§ 5. Submission. This proxy shall be filed with and submitted to the Corporate Secretary of the Corporation on or before the deadline prescribed in the By-Laws of the Corporation or in the notice of the meeting, in accordance with Section 57 of the Revised Corporation Code and the Corporation's internal rules.
§ 6. Data Privacy. The undersigned consents to the collection, use, and processing of his/her personal data contained herein by the Corporation solely for purposes of the validation, recording, and exercise of this proxy, in accordance with Republic Act No. 10173, otherwise known as the Data Privacy Act of 2012, and its Implementing Rules and Regulations.
IN WITNESS WHEREOF, the undersigned has hereunto set his/her hand this ________ at ________, Philippines.
_______________________________
________
Stockholder
CONFORME (Proxy):
_______________________________
________
Proxy
SIGNED IN THE PRESENCE OF:
_______________________________ _______________________________
________ ________
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
________ ) S.S.
BEFORE ME, a Notary Public for and in the above jurisdiction, this ________, personally appeared ________, who proved to me his/her identity through the competent evidence of identity consisting of ________, known to me and to me known to be the same person who executed the foregoing Proxy, and who acknowledged to me that the same is his/her free and voluntary act and deed.
WITNESS MY HAND AND SEAL on the date and at the place first above written.
_______________________________
NOTARY PUBLIC
Doc. No. ________;
Page No. ________;
Book No. ________;
Series of ________.