PROXY FORM
General assembly of co-owners — [Building name]
Meeting date: [DD/MM/YYYY]

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THE UNDERSIGNED (owner giving the proxy)
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Name:              _________________________________________
Unit:              ______     Permillage: ______ ‰
Address:           _________________________________________
Email:             _________________________________________
Phone:             _________________________________________

HEREBY APPOINTS (proxy holder)

Name:              _________________________________________
Capacity:          [ ] Fellow co-owner   [ ] Third party
Address:           _________________________________________
Email / phone:     _________________________________________

to represent me at the general assembly of the co-owners of
[Building name], convened on [DD/MM/YYYY], and to vote on my
behalf on all items of the agenda under the instructions below.

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VOTING INSTRUCTIONS
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  [ ] Free mandate — my proxy holder votes at their discretion
  [ ] Bound mandate — vote as follows:

Resolution         For   Against   Abstain
1. ______________  [ ]     [ ]       [ ]
2. ______________  [ ]     [ ]       [ ]
3. ______________  [ ]     [ ]       [ ]
4. ______________  [ ]     [ ]       [ ]
5. ______________  [ ]     [ ]       [ ]

(Attach additional sheet if needed)

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DECLARATION
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I confirm that this proxy is given freely and that I have read
the agenda and supporting documents circulated with the notice.

Signed at:     _______________________
Date:          [DD/MM/YYYY]

Owner signature:        ______________________________

Proxy holder signature: ______________________________
(acknowledging the mandate)

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NOTES
- Return this form to [syndic email / address] before the
  meeting, or hand it to the chair at the start of the session.
- Limits on the number of proxies one person may hold, and on
  who may act as proxy, vary by jurisdiction — check the
  co-ownership regulation.