The Pamphlet Collection of Sir Robert Stout: Volume 88

Form of Proxy

Form of Proxy.

I hereby appoint___my proxy, to vote for me and in my name at a meeting of the members of The Wellington and Hutt Building Society, 1875., to be holden on the___and at any adjournment of such meeting.

Dated at___this day of 187 Signature.......................... Holder of___Shares.

Printed by Lyon and Blair, Lambton Quay, Wellington.