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HEREBY GIVING AND GRANTING unto said attorney-in-fact and proxy full
power and authority to do and perform every legal act and thing whatsoever
requisite or necessary to be done in and about the premises as fully to all intents
and purposes as I might or could lawfully do, and hereby ratifying and
confirming all that my said attorney-in-fact and proxy shall lawfully do or cause
to be done by virtue hereof.
Unless revoked, this Proxy shall be effective for the aforestated meeting of
stockholders.
IN WITNESS WHEREOF, I have hereunto affixed my signature this
____ day of _____________________ at
____________________________________.
Affiant
ID No. ________________
ACKNOWLEDGMENT
Notary Public
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