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The Pamphlet Collection of Sir Robert Stout: Volume 7

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


Holder of________Shares.

Printed by Lyon and Blair, Lambton Quay, Wellington.