[Title as in Form No. 53A]
I/We, ..... of ... a creditor [or member] hereby appoint [Note 1] .... as my/our proxy at the meeting of creditors [or members] to be held on the ... day of ..., 20... or at any adjournment thereof to vote [Note 2] ....... the resolution No .... [Note 3] ... in the notice convening the said meeting.
(Signed) [Note 4]
[Note 1] The person appointed special proxy may be the Examiner or such other person (not being a child) as the creditor [or member] may appoint.
[Note 2] Here insert the word "for" or the word "against" as the case may require.
[Note 3] Specify the particular resolution.
[Note 4] If a firm, sign the firm's trading title and add "by A.B. a partner in the said firm". If the appointor is a corporation, the form of proxy must be under its common seal or under the hand of some officer duly authorised in that behalf, and the fact that he is so authorised must be so stated.
[Note 5] The proxy form when signed must be lodged with the Examiner no later than 4.00 in the afternoon of the day before the meeting at the address stated for that purpose in the notice convening the meeting at which it is to be used.
[Note 6] For rules on the conduct of meetings, see Order 53A, rule 17 of the Circuit Court Rules.
Form 53C inserted by SI 284 of 2014, effective 14 July 2014.