This form can be used to appoint a proxy to attend a meeting to vote on the establishment of a park liaison committee. You can copy and paste this content to create your own form. 

I/We,

(insert name/s)

the tenant/s of

(insert site number and name of caravan or residential park)

appoint

(insert name of proxy holder)

of

(insert address of proxy holder)

as my proxy to vote whether or not to establish a park liaison committee

at the meeting of long-stay tenants on:

                                                                                                            (insert date of meeting)

(signature of long-stay tenant/s)

(Date)

This form cannot be used to appoint a park operator, representative or close associate of the park operator as proxy.

This form is to be given to the chairperson before the vote is held.

This form is a suggested form only and is not required to be used.