MILLWOOD HOMEOWNERS’ ASSOCIATION

PROXY BALLOT FORM

 I ____________________________, property owner of _________________

                                                                                                   (Address of Property)

award my vote by this proxy to _________________________ for issues

brought during the Millwood Homeowners’ Association Annual Meeting.  This proxy expires at the conclusion of the meeting to be held ____________, at ______ p.m. at the Englewood Government Center.

Homeowner Signature

Proxy Holder’s Signature

Date Awarded