AGM PROXY FORM 2020

ONLINE PROXY FORM SUBMISSION

To be effective, this online proxy form must be completed and submitted by 5:00pm on Monday 26th October 2020. If a certified true copy of the power of attorney is required to support the proxy nomination this must be mailed to the Society’s registered office, 3 Burwood Highway, Burwood East VIC 3151 or emailed to governance@rspcavic.org.au by the same date and time, clearly stating the corresponding member’s name and membership number.

Question Title

* 1. Please enter your details

Name *

Address *

Address 2

Suburb *

State *

Postal Code *

Email Address

Phone Number

Question Title

* 2. Please enter your RSPCA Supporter ID number

(You can find your Supporter ID number listed on the email inviting you to the AGM or on your Membership card)

Question Title

* 3. Please nominate your proxy

(Being a member of the RSPCA Victoria, pursuant to my right to appoint a proxy, appoint the following person as my proxy to vote for me and on my behalf at the Annual General Meeting to be held digitally on Wednesday 28th October 2020 at 5:00pm or at any adjournment of that meeting. )

The Chairperson of the Meeting

Other - Please enter the name or office held by the person you would like to appoint:

Voting Directions

(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)

I direct my proxy to vote as follows:

Question Title

* 4. Re-election of Mr Bernie Delaney as Director

For

Against

Abstain

I do not direct my proxy how to vote

Question Title

* 5. Re-election of Dr Jason Rapke as Director

For

Against

Abstain

I do not direct my proxy how to vote

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* 6. The exercise of power under this proxy is restricted as follows:

(Please type any restrictions which apply here - if left blank, no restrictions apply)

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* 7. I acknowledge that this proxy form will be submitted for the RSPCA Victoria’s 2020 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.

Question Title

* 1. Please enter your details

Question Title

* 2. Please enter your RSPCA Supporter ID number(You can find your Supporter ID number listed on the email inviting you to the AGM or on your Membership card)

Question Title

Question Title

* 4. Re-election of Mr Bernie Delaney as Director

Question Title

* 5. Re-election of Dr Jason Rapke as Director

Question Title

* 6. The exercise of power under this proxy is restricted as follows: (Please type any restrictions which apply here - if left blank, no restrictions apply)

Question Title

* 7. I acknowledge that this proxy form will be submitted for the RSPCA Victoria’s 2020 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 RSPCA Supporter ID number

(You can find your Supporter ID number listed on the email inviting you to the AGM or on your Membership card)

* 6. The exercise of power under this proxy is restricted as follows:

(Please type any restrictions which apply here - if left blank, no restrictions apply)