REVOCABLE
PROXY
For
payment of one dollar ($1) and other compensation, I hereby confer upon
________ _____________________________ a proxy to vote ________________ ( ___ )
shares of _____________________ (hereinafter "Corporation") in my
stead and on my behalf at the Corporation shareholders' meeting to be held on
_____________________, and at all subsequent regular and special meetings of
shareholders of the Corporation. Said
person shall have all the power to vote and attend meetings as I currently
enjoy. Until this proxy is revoked,
which act may be executed without notice, I shall not vote the shares
represented.
_______________________________
________________
Signed
Date
