Spousal Consent Voting Form

Spousal Consent Voting Form
Please complete this form to record your consent and vote on the specified matter. All information will be kept confidential.
Spouse 1 Full Name
First NameLast Name
Spouse 2 Full Name
First NameLast Name
Spouse 1 Email Address
example@example.com
Spouse 2 Email Address
example@example.com
Spouse 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Spouse 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Matter Subject to Consent/Vote
Please indicate your vote regarding the matter above
Additional Comments (optional)
Spouse Signatures (both spouses must sign)
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Date of Submission
MonthDayYear
Date
Should be Empty: