Shareholder Meeting Waiver of Notice Form

Shareholder Meeting Waiver of Notice Form
Use this form to identify the shareholder and meeting details, acknowledge waiver of advance notice, and provide signature authorization for the stated meeting.
Shareholder and Company Information
Shareholder full name
First NameMiddle NameLast Name
Shareholder type
Mailing address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Email address
example@example.com
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Company name
Class/series of shares owned
Number of shares owned or represented
Meeting Details and Waiver Acknowledgement
Meeting Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Meeting Time
Hour Minutes
AM/PM Option
Meeting Location or Virtual Link
Meeting Type
Meeting Title / Purpose
Waiver of Notice Acknowledgement
Waiver Scope Acknowledgement
Authorization and Signature
Signer Name
First NameMiddle NameLast Name
Title or Relationship to Shareholder
Authority to Sign on Behalf of the Shareholder/Entity
Signature
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Date Signed
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: