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Proxy Form For FAB
Proxy Form For FAB
NAME OF PROXY
as the PROXY of the undersigned at the Regular Meeting of the GENERIKA FRANCHISE ADVISORY
BOARD to be held on 16/17 February 2018, at XX:00 X.M. at
_____________________________________________, and at any postponement or adjournment
thereof.
Franchise Name
Franchisee
By:
__________________________________
NAME OF PROXY
Attorney-in-Fact