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BJMP MBAI Proxy to Vote Form

BJMP form for proxy to vote

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Bureau of Jail Management and Penology
Bureau of Jail Management and Penology
Mutual Benefit Association, Incorporated
Mutual Benefit Association, Incorporated

144 Mindanao Avenue,Avenue, Bahay Toro, Quezon City, Metro Manila Tel.: 02-926-6963
144 Mindanao Bahay Toro, Quezon City, Metro Manila Tel.: 02-926-6963

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PROXY TO VOTE
PROXY TO VOTE
KNOW ALL MEN BY THESE PRESENTS:
KNOW ALL MEN BY THESE PRESENTS:
The undersigned, a member of BJMP BJMP Mutual Benefit Association, Inc. (BJMPMBAI), a
The undersigned, a member of Mutual Benefit Association, Inc. (BJMPMBAI), a
mutual benefit association that isthat isorganized and existing under under the laws of the Philippines,
mutual benefit association duly duly organized and existing the laws of the Philippines,
hereby makes, constitutes, and appoints
hereby makes, constitutes, and appoints
________________________________________________
________________________________________________
( NameName of Proxy )
( of Proxy )
to be to be hisand lawful lawful attorney, agent, or proxy, for and name to vote atvote at the general
his true true and attorney, agent, or proxy, for and in his in his name to the general
assembly meeting of members of the of the Association, held on July 1, July 4, herebyhereby revoking all
assembly meeting of members Association, to be to be held on 2013; 2015; revoking all
proxies heretofore given given to any personperson or persons and hereby ratifying and confirming all
proxies heretofore to any other other or persons and hereby ratifying and confirming all
that said attorney, agent,agent, or proxylawfully do or do or cause done by virtue virtue hereof.
that said attorney, or proxy may may lawfully cause to be to be done by hereof.
Witness the hand of the of the undersigned, this ________day of _____________, 2015.
Witness the hand undersigned, this ________day of _____________, 2013.
*Name: ___________________________ Rank: _____ Badge No.: ______________
*Name: ___________________________ Rank: _____ Badge No.: ______________
Region: Province: _____________________ Jail: Jail: ___________________________
Region: ____ ____ Province: ________________________________________________

(Signature)
(Signature)

(Right Thumb mark)
(Right Thumb mark)

SUBSCRIBED AND SWORN to
of _______2015 at
SUBSCRIBED AND SWORN to beforebefore this this ____day_______2013 at
me me ____day of
_____________, ____________________,
_____________, ____________________, Philippines. Philippines.
( PHOTOCOPY OF VALID ID MUST BE ATTACHED )
( PHOTOCOPY OF VALID ID MUST BE ATTACHED )

__________________________
__________________________
Officer Administering Oath
Officer Administering Oath

MEMBER’S DUPLICATE COPY COPY
MEMBER’S DUPLICATE
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_____ _____

PROXY TO VOTE VOTE
PROXY TO
KNOW KNOW ALL MEN BY THESE PRESENTS:
ALL MEN BY THESE PRESENTS:
The undersigned, a member of BJMP Mutual Benefit Association, Inc. (BJMPMBAI), a mutual benefit
The undersigned, a member of BJMP Mutual Benefit Association, Inc. (BJMPMBAI), a
benefitassociation that is is duly organized and existing under the laws the the Philippines, hereby makes,
association that duly organized and existing under the laws of of Philippines, hereby makes, constitutes,
constitutes, and appoints
and appoints
________________________________________________
________________________________________________
( Name Name of Proxy )
( of Proxy )
to be his be his true and attorney, agent, agent, or proxy, for and name to vote to vote general general assembly
to true and lawful lawful attorney, or proxy, for and in his in his name at the at the assembly
meeting of members of the of the Association, held on Julyon July 4, hereby hereby revoking all proxies heretofore
meeting of members Association, to be to be held 1, 2013; 2015; revoking all proxies heretofore
given to any to any person person or persons and hereby ratifying and confirming all that said attorney, or
given other other or persons and hereby ratifying and confirming all that said attorney, agent, agent, or
proxy may lawfully do or cause to be done by virtue hereof.
proxy may lawfully do or cause to be done by virtue hereof.
Witness the hand of the undersigned, this ________day of _____________, 2013. 2015.
Witness the hand of the undersigned, this ________day of _____________,
*Name: ________________________________ _____ Badge No.: ______________
*Name: ________________________________ Rank:Rank: _____ Badge No.: ______________
Region: ____ Province: ____________________________ Jail: ___________________________
Region: ____ Province: ____________________________ Jail: ___________________________

(Signature)
(Signature)

(Right Thumb
(Right Thumb mark)mark)

SUBSCRIBED AND
SUBSCRIBED AND SWORN toSWORN me this ____day of this ____dayat of _______2015
before to before me
_______2013
_____________,
_____________, ____________________, Philippines.
____________________, Philippines.
( PHOTOCOPY OF VALID ID MUST BE ATTACHED )
( PHOTOCOPY OF VALID ID MUST BE ATTACHED )

___________________________
___________________________
Officer Administering Oath
Officer Administering Oath

at
 
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