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Proxy form and Attendance Slip for Annual General Meeting

Template/format of Proxy Form and Attendance Slip for Annual General Meeting (AGM) of any Company:
XYA LIMITED
Regd. Office: Address, City, State, Pin

CIN: ____________________

PROXY FORM



DP Id


Client Id


Regd. Folio No.


No. of Shares




I/We (Name(s) and address of the shareholder in full)                         being a shareholder of XYA Limited, hereby appoint                         of         in the district of                         or failing him / her          of         in the district of                        as my/our Proxy to attend and vote for me/us on my/our behalf at the ___th annual general meeting of the Company being held on ___day, __date, month, year at (time) at (address) or /and at any adjournment thereof.

I/We direct my/our Proxy to vote on the resolution(s) in the manner as indicated below:


Resolutions

For

Against














Affix the Revenue Stamp


Dated: __________________

_______________________

Signature of the Shareholder / Proxy

Notes:
(1) The Proxy form duly completed and signed should be received at the Registered Office of the Company situated at (Address) not less than 48 hours before the time appointed for holding the meeting or any adjournment thereof.

(2) 

Full name(s) and address(es) to be inserted in BLOCK CAPITALS.
(3) 

A member of the Company entitled to attend and vote at the above meeting is entitled to appoint one or more proxies to attend and, on a poll, to vote instead of him. The proxy need not be a member of the Company but must attend the Meeting in person to represent you.
(4) IMPORTANT: IF YOU WISH TO VOTE FOR A RESOLUTION, PLEASE PLACE A “√” IN THE RELEVANT BOX under “FOR”. IF YOU WISH TO VOTE AGAINST A RESOLUTION, PLEASE PLACE A “√” IN THE RELEVANT BOX under “AGAINST”. Failure to complete the boxes will entitle your proxy to cast his vote at his discretion. Your proxy will also be entitled to vote at his discretion on any resolution properly put to the meeting other than those referred to in the notice convening the meeting.

(5) In the case of a body corporate this form must be executed either under its common seal or under the hand of an officer or attorney duly authorised. A copy of the authorisation of such officer or attorney must be lodged with the form of proxy.

(6) 

Any alterations made in this form of proxy must be initialled by the person who signs it.
(7) Please mark the envelop while sending as ‘Proxy Documents’.
(8) Any Discrepancy found in the proxy form will stand rejected.

--------✄---------------- cut here ---------------- cut here ------------------------

XYA LIMITED

Regd. Office: Address, City, State, Pin

CIN: ____________________
ATTENDANCE SLIP


Members or their proxies are requested to present this form for admission, duly signed in accordance with their specimen signatures registered with the Company.



DP Id


Client Id


Regd. Folio No.


No. of Shares





Name(s) and address of the shareholder in full _________________________________________.

I/we hereby record my/our presence at the ___th annual general meeting of the Company being held on ___day, __date, month, year at (time) at (address).


Please (√) in the box

MEMBER □ PROXY □

__________________________

Signature of Shareholder / Proxy 
Submit/See Comments With: or

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