Annual General Meeting Proxy Form

Your completed proxy form, together with any additional documentation, must be received by RSPCA Victoria by 5:00pm Monday 24 October 2022. Forms received after this date will not be included in the formal counting of votes. Forms can be returned by completing the online form (preferred); or by emailing a scanned copy to governance@rspcavic.org.au; or by posting the form sent out via mail to our registered office at 3 Burwood Highway, Burwood East VIC 3151 using the supplied reply paid envelope.

Question Title

* 1. Please enter your details

Name

Address

City/Town

State

Postal Code

Email Address

Phone Number

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* 2. Please enter your Membership ID number

(You can find your ID number listed on your active membership card)

Voting Directions

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* 3. I do not direct my proxy how to vote

True

False

OR

(If you mark the Abstain box for a particular item, you are directing your proxy not to vote on your behalf on a poll, and your votes will not be counted in computing the required majority on a poll)

Question Title

* 4. Re-election of Ms Carole Webb as Director

For

Against

Abstain

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* 5. Re-election of Ms Mary Anne Hartley as Director

For

Against

Abstain

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* 6. The exercise of power under this proxy is restricted as follows:
(Legibly write any Restrictions which apply here – if blank, no restrictions apply.)

Question Title

* 7. I acknowledge that this proxy form will be submitted for the RSPCA Victoria’s 2022 Annual General Meeting. I declare that my name and contact details are correct, I am an active RSPCA Victoria member and am not a paid employee of RSPCA Victoria at the time of this submission.

Annual General Meeting Proxy Form

Question Title

* 1. Please enter your details

Question Title

* 2. Please enter your Membership ID number(You can find your ID number listed on your active membership card)

Question Title

* 3. I do not direct my proxy how to vote

Question Title

* 4. Re-election of Ms Carole Webb as Director

Question Title

* 5. Re-election of Ms Mary Anne Hartley as Director

Question Title

* 6. The exercise of power under this proxy is restricted as follows:(Legibly write any Restrictions which apply here – if blank, no restrictions apply.)

Question Title

* 7. I acknowledge that this proxy form will be submitted for the RSPCA Victoria’s 2022 Annual General Meeting. I declare that my name and contact details are correct, I am an active RSPCA Victoria member and am not a paid employee of RSPCA Victoria at the time of this submission.

* 2. Please enter your Membership ID number

(You can find your ID number listed on your active membership card)

* 6. The exercise of power under this proxy is restricted as follows:
(Legibly write any Restrictions which apply here – if blank, no restrictions apply.)