Limited
FOR OFFICE USE ONLY
MEMBER VOTING LIMITED POWERS PROXY
DATE
RECEIVED_
MEMBER #
To: National Society of Public Accountants dba National Society of Accountants 1330 Braddock Place Ste. 540 Alexandria, VA 22314-1650
VERIFIED BY VERIFIED: YES_
NO_
Limited Powers I, the undersigned Active/Life Member of the National Society of Accountants, hereby appoint the Immediate Past President of the Society, as nominee, and proxy with powers of substitution for and in the name and place of the undersigned, to cast votes only as I specifically instruct on the following matters to come before the Annual Meeting of the members of the National Society of Accountants, to be held in Tampa, Florida on August 18, 2016, and at any adjournment or adjournments thereof. This proxy shall b be void if I personally attend the meeting.
SAMPLE Do NOT Submit to NSA
IN WITNESS WHEREOF, I have executed this proxy on
, 2016.
Signature
Print Name
NSA Member #
Email
Telephone # Address
City, State, Zip
Please initial the name of the individual for whom you direct the Immediate Past President of the Society to vote on your behalf as an Officer or District Governor. President: First Vice-President Second Vice-President
________ Alfred Giovetti ________ Brian Thompson ________ Christine Freeland or ________ William Silzer
District Governors: District II District IV District VI District VIII District X
________ Robert Genovese ________ Dave Rancourt ________ Debra Cope ________ Marchelle Foshee ________ Ruth Godfrey
Limited Powers Proxy Information and Guidelines To authorize a proxy who will cast votes on your behalf at the Annual Meeting of the National Society of Accountants you must be an Active or Life Member of the Society in good standing on July 15, 2016 and your proxy authorization must be received at the NSA office by 5:00pm EDT on Sunday, August 7, 2016. You are only allowed to designate a proxy if you will not be in attendance at the Annual Convention. There are two forms of authorization Limited Powers and General Powers: This is the Limited Powers Proxy and will authorize the Immediate Past President of the Society to vote for the individuals you designate in the proxy. Your Proxy Designation must be signed, dated and provide your member number for verification purposes. For more information on candidates, Proxy Voting and the convention rules, please go to the NSA home page. You may submit your proxy authorization online, by mail, fax or email. Mail: National Society of Accountants, 1330 Braddock Place Ste. 540, Alexandria, VA 22314-1650. Email: [email protected] FAX: 1-703-549-2984
MEMBER VOTING LIMITED POWERS PROXY
DATE
RECEIVED_
MEMBER #
To: National Society of Public Accountants dba National Society of Accountants 1330 Braddock Place Ste. 540 Alexandria, VA 22314-1650
VERIFIED BY VERIFIED: YES_
NO_
Limited Powers I, the undersigned Active/Life Member of the National Society of Accountants, hereby appoint the Immediate Past President of the Society, as nominee, and proxy with powers of substitution for and in the name and place of the undersigned, to cast votes only as I specifically instruct on the following matters to come before the Annual Meeting of the members of the National Society of Accountants, to be held in Tampa, Florida on August 18, 2016, and at any adjournment or adjournments thereof. This proxy shall b be void if I personally attend the meeting.
SAMPLE Do NOT Submit to NSA
IN WITNESS WHEREOF, I have executed this proxy on
, 2016.
Signature
Print Name
NSA Member #
Telephone # Address
City, State, Zip
Please initial the name of the individual for whom you direct the Immediate Past President of the Society to vote on your behalf as an Officer or District Governor. President: First Vice-President Second Vice-President
________ Alfred Giovetti ________ Brian Thompson ________ Christine Freeland or ________ William Silzer
District Governors: District II District IV District VI District VIII District X
________ Robert Genovese ________ Dave Rancourt ________ Debra Cope ________ Marchelle Foshee ________ Ruth Godfrey
Limited Powers Proxy Information and Guidelines To authorize a proxy who will cast votes on your behalf at the Annual Meeting of the National Society of Accountants you must be an Active or Life Member of the Society in good standing on July 15, 2016 and your proxy authorization must be received at the NSA office by 5:00pm EDT on Sunday, August 7, 2016. You are only allowed to designate a proxy if you will not be in attendance at the Annual Convention. There are two forms of authorization Limited Powers and General Powers: This is the Limited Powers Proxy and will authorize the Immediate Past President of the Society to vote for the individuals you designate in the proxy. Your Proxy Designation must be signed, dated and provide your member number for verification purposes. For more information on candidates, Proxy Voting and the convention rules, please go to the NSA home page. You may submit your proxy authorization online, by mail, fax or email. Mail: National Society of Accountants, 1330 Braddock Place Ste. 540, Alexandria, VA 22314-1650. Email: [email protected] FAX: 1-703-549-2984
