PROXY

 

KNOW ALL MEN BY THESE PRESENTS:

 

That I, ______________________________________________, the undersigned duly elected member of the Republican State Committee from Congressional District _________, *Legislative District __________, and __________________ County, State of Arizona, do hereby constitute and appoint 

__________________________________________________

(Name)

who is a registered Republican and qualified elector of Congressional District_______,*Legislative District __________,and __________________ County, State of Arizona  my attorney-in-fact and proxy to vote for me in my name and stead, at the Statutory meeting of Republican State Committeemen to be held at 9:00AM on January 27, 2007, at Sunnyslope High School at 35 W Dunlap Ave
Phoenix, AZ 85021
for the transaction of any and all business that may properly  come  before the meeting , I do hereby approve, ratify and confirm all of the acts of my said proxy.

WITNESS my hand this _________day of __________. 2007

 

 

 

________________________________________________

Member of the Republican State Committee of Arizona

 

NOTE: The signature of the state committeeman shall be witnessed by two individuals other than the two principals OR attested to by a Notary Public.

 

 

 

x_______________________                          x__________________________________

(Witness)                                                                      (Witness)                                 

 

 

 

STATE OF ARIZONA                 )

                                                      )

COUNTY OF _______________)

 

            This instrument was acknowledged before me this _____day of ____________________, 2005

 

_

__________________________________

Notary Public                                   .

My Commission Expires:                                                                     

 

_______________________________________

 

 

* Counties of at least 500,000 populations only.