ASC Z97 Full Committee Meeting

I, the undersigned, do hereby give my full and unrestricted authority and proxy to vote in my place and stead all the power and authority I have to vote as a member of the ASC Z97 Committee to:

Question Title

* 1. (Name of person and their company to receive proxy)

Question Title

* 2. This proxy is valid for the meeting/teleconference being held on:

This proxy shall expire immediately upon termination of the above noted meeting on the date so stated. If the Committee Member is able to participate, the proxy is void and of no effect.

Question Title

* 3. (Your Name and company)