P.O. Box 481, Natick, MA 01760
To the Secretary of New England DS, Inc.:
The undersigned member of New England DS, Inc. (NEDS) hereby appoints ___________________________________ (the President of NEDS if no name provided) as his or her true and lawful attorney and proxy of the undersigned with full power of substitution to cast my vote at the annual meeting of members to be held on ___________________, or on such other date as the meeting may otherwise be continued, for any matters that shall properly come before the meeting with no exceptions and to vote for:
___________________________________ as service board member.
This proxy is granted in accordance with the provisions of the By-Laws of New England DS, Inc. and shall be effective until the undersigned gives written notice to the Secretary of the Corporation that this proxy has been revoked.
Executed as a sealed instrument this _____ day of __________ , 2016.
Scene Name: _____________________________________
Proxy will be valid and accepted provided postmarked prior to or no later than ________________________ or received, in hand, no later than the time of the vote at the annual meeting.
NOTE: If it is necessary to postpone the above scheduled Annual Meeting because of adverse weather conditions or other safety factors, the alternate date for the Annual Meeting will be ____________________________, at the same location that had been announced to the NEDS membership in the official notice of the Annual Meeting.