I, ______________________, being a stockholder of ________________________ (Corporation) (hereinafter "Corporation"), does hereby grant and confer power of attorney and proxy to __________________________ to represent my shares at any and all regular and special meetings of the shareholders of said Corporation. This power of attorney and proxy shall exist for a duration of time not extending beyond ______________________ (Date).
Said proxy will not be limited in exercising all of the rights and privileges as I would regularly enjoy as pertains to voting, discussion, or any other matter arising for consideration and action during business of said meetings, acting on my behalf.
These forms are provided AS IS. They may not be any good. Even if they are good in one jurisdiction, they may not work in another. And the facts of your situation may make these forms inappropriate for you. They are for informational purposes only, and you should consult an attorney before using them.