SPECIAL POWER OF PROXY

  Name:_______________________________________________

  Address:_____________________________________________

City/State/Zip:_________________________________________

 

I hereby appoint _____________________________________as my Agent, and provide him/her with full power and authority to vote my proxy on any matters relating to the Crow River Investment Club meeting on_________________________.
                      (date)

My Agent shall:

Not be liable for any loss that results from a judgment that was made in good faith;

Not be entitled to any compensation for any services provided as Agent;

Provide an accounting for all acts performed as my Agent, if I so request, or if such a request is made by an authorized personal representative or fiduciary acting on my behalf.

_____________________________________________
Signature                           Date

 

SPECIAL POWER OF PROXY

Name:_______________________________________________

Address:_____________________________________________

City/State/Zip:________________________________________


I hereby appoint _____________________________________as my Agent, and provide him/her with full power and authority to vote my proxy on any matters relating to the Crow River Investment Club meeting on_________________________.
                     (date)

My Agent shall:

Not be liable for any loss that results from a judgment that was made in good faith;

Not be entitled to any compensation for any services provided as Agent;

Provide an accounting for all acts performed as my Agent, if I so request, or if such a request is made by an authorized personal representative or fiduciary acting on my behalf.

_____________________________________________
Signature                           Date

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