Form of special proxy

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Full Text of the Document

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....or [or contributory] hereby appoint......as my/our proxy at the meeting of creditors [or contributories] to be held on the ..........day of ........20...., or at any adjournment thereof, to vote. [Here insert the word 'for' or the word 'against', as the case may require, and specify the particular resolution] the resolution numbered.......in the notice convening the meeting. Dated this........day....