PROXY FORM

ACCOUNT_JOB_COMPANY
ACCOUNT_COMPANY_REG_NO

DATE GENERAL MEETING

For use by shareholders for the General Meeting to be held on DATE at ADDRESS

I (block capitals) NAME of ADDRESS being a holder of  ordinary shares of CURRENCYPAR in the capital of the Company, hereby appoint the Chairman or failing him, PROXY  as my proxy to vote for me and on my behalf at the General Meeting of the Company to be held on DATE and at any adjournment thereof.

I direct my proxy to vote in the manner indicated by an X in the appropriate column.  Unless otherwise indicated, or upon any matter properly put before the meeting but not referred to below, my proxy may exercise his / her discretion as to how he/she votes and whether or not he /she abstains from voting. 

	For	Against	Vote withheld
Ordinary Resolutions
1.  THAT #insert text of resolution#
2.  THAT #insert text of resolution#
Special Resolutions
3.  THAT #insert text of resolution#
4.  THAT #insert text of resolution#
5.  THAT #insert text of resolution#

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