Legal Proxy Voting Objection Form

LEGAL PROXY VOTING OBJECTION FORM

Date of Submission:    Objector Name:    Capacity of Objector:

Objector Address:

Company / Issuer:    Record Date:

Meeting Date:    Meeting Time:    Meeting Location:

Proxy Holder (whose vote is objected to):

RECITALS

WHEREAS, Objector is a person entitled to challenge the exercise of voting power arising from a proxy at the meeting described above; and

WHEREAS, a proxy vote has been cast by or on behalf of the Proxy Holder for one or more agenda items at the Meeting, and Objector asserts that the proxy vote is invalid or should otherwise be disregarded for the reasons set forth herein; and

WHEREAS, Objector submits this written objection to preserve and document the objection and to request administrative or judicial relief as may be appropriate.

NOW THEREFORE

In consideration of the foregoing recitals and the mutual covenants contained herein, Objector hereby states the following objection and requests relief as provided below.

1. OBJECTION

Objector hereby objects to the validity and/or count of the proxy vote cast by the Proxy Holder described above with respect to the following agenda item(s) and votes:

2. GROUNDS FOR OBJECTION

Objector asserts the proxy vote is invalid for one or more of the following grounds (check all that apply and provide a factual explanation in Section 3):

Lack of actual authority by the proxy holder to vote the shares.

Proxy revoked prior to voting.

Material deficiency or omission in proxy disclosure affecting consent.

Conflict of interest or prohibited transaction by the proxy holder.

Procedural irregularity in the casting, recording, or counting of the proxy.

Fraud, undue influence, or misrepresentation pertaining to the proxy.

3. STATEMENT OF FACTS

Provide a concise, chronological statement of facts supporting the objection. Identify dates, documents, communications, and witnesses that substantiate the grounds checked above.

4. EVIDENCE AND ATTACHMENTS

List all documents, affidavits, correspondence, account statements, proxy instruments, and other evidence submitted in support of this objection.

5. RELIEF REQUESTED

Objector requests the following relief (check all that apply and describe any additional relief):

Declare the proxy vote invalid and remove it from the tabulation.

Instruct that the proxy be treated as abstention.

Order recount or re-tabulation of votes for the affected item(s).

Recognize a valid revocation of the proxy and disregard subsequent vote.

6. CERTIFICATION OF AUTHORITY

Select the capacity in which Objector submits this form and provide any identifying information necessary to establish authority.

I am the registered shareholder of record.

I am the beneficial owner of the shares.

I am the attorney-in-fact or authorized agent for the shareholder (attach proof of authority).

7. NOTICE INFORMATION

8. RESERVATION OF RIGHTS

Objector reserves all rights to seek equitable and legal relief, including, without limitation, injunctive relief and examination of the proxy instrument, and does not waive any rights or defenses by filing this form. This objection is made without prejudice to any subsequent claims or defenses.

9. MISCELLANEOUS

Governing Law: This objection shall be governed by and construed in accordance with the laws of the state indicated by the Company or, if none is indicated, the state of incorporation of the Company, without regard to conflict of law principles.

Entire Agreement: This form, together with any attachments and supporting documents expressly incorporated by reference, constitutes the entire written statement of objection submitted by Objector with respect to the matters addressed herein.

Severability: If any provision of this objection is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Amendments and Waiver: No amendment or waiver of any provision of this objection shall be effective unless in writing and signed by the Objector. Failure to enforce any right shall not constitute a waiver of that right.

10. CERTIFICATION

By signing below, Objector certifies under penalty of perjury that the statements made in this objection are true and correct to the best of Objector's knowledge and that Objector is authorized to submit this objection on the basis indicated above.

I certify under penalty of perjury that the foregoing is true and correct.

Sign Now