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Official Proxy

PROXY WITH FULL POWER OR SUBSTITUTION

I, ____________________________________________, do hereby appoint ________________________________________ to be my proxy agent with full power of substitution and to vote for me in all business matters to be considered at the meeting of the Democratic Party of Carroll meeting on the following date, ________________. My appointee shall have all the power that I would possess with respect to voting and granting my consent. I hereby ratify and confirm all acts that my proxy shall so or cause to be done by virtue of and within the limitations set forth in this proxy.

This proxy voids and supersedes any proxy heretofore executed by me, and in the event I will attend the meeting dated above, I reserve the right to revoke this proxy and vote in person.

__________________________________ DPCC Member Signature

__________________________________ Printed Name

Carroll County Democratic Party

PO Box 8

Eureka Springs, AR 72632

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