I,＿＿（1）＿＿,of＿＿（2）＿＿,hereby appoint＿＿（3）＿＿,of＿＿（4）＿＿,as my attorney in fact to act in my capacity to do every act that I may legally do through an attorney in fact. This power shall be in full force and effect on the date below written and shall remain in full force and effect until＿＿（5）＿＿or unless specifically extended or rescinded earlier by either party.
我，＿＿（名字），＿＿（地址等），在此指定＿＿（名字），＿＿（地址或律师事务所名字等），为我的律师，以我的身份履行所有实践中我通过律师所能从事的合法行为。本权利在以下载明日期全权生效并一直持续到＿＿或持续到双方当事人规定的延展期或提前撤销期。
Dated＿＿（6）＿＿,20＿（7）＿. ＿＿（8）＿＿
STATE OF＿＿（9）＿＿ （签名处）
COUNTY OF＿＿（10）＿＿
日期：＿＿
地址：＿＿
州名和县名：＿＿
PROXY委托书
BE IT DNOWN, that I,＿＿（1）＿＿,the undersigned Shareholder of＿＿（2）＿＿,a＿＿（3）＿＿corporation, hereby constitute and appoint＿＿（4）＿＿as my true and lawful attorney and agent for me and in my name, place and stead, to vote as my proxy at the Meeting of the Shareholders of the said corporation, to be held on＿＿（5）＿＿or any adjournment thereof, for the transaction of any business which may legally come before the meeting, and for me and in my name, to act as fully as I could do if personally present; and I herewith revoke any other proxy heretofore given.
兹有我，＿＿（名字），为＿＿（公司名字及性质）的以下署名股东，在此任命和指定＿＿（名字）为我的事实和合法授权代理人，为我和以我的名义、职位和身份，在上述公司于＿＿（日期）召开的或就此延期召开的股东大会上作为我的代理人对与会前合法提交大会讨论的任何事情进行表决，且为我和以我的名义，在大会上全权履行我的职责；在此我撤销此前所作的任何其他授权委托。
WITNESS my hand and seal this＿＿（6）＿＿day of＿＿（7）＿＿,20＿＿（8）＿＿.
于20＿＿年＿＿月＿＿日签字盖章，特此为证。
