COPPER HILL FOUR HOMEOWNER'S ASSOCIATION, INC.
LIMITED PROXY FORM
Print and mail to P.O. Box 77574 Jacksonville, Florida 32218
The undersigned owners or thier voting representatives of LOT # _________in COPPER HILL FOUR HOMEOWNER'S
ASSOCIATION, INC., hereby constitutes and appoints _____________________________________________, as a
proxy with powers of substitution for and in the name and place of the undersigned, to appear, represent, and cast
votes only as I specifically intrust in reference to the following matters to come before the COPPER HILL FOUR
HOMEOWNER'S ASSOCIATION, INC. Annual election to be held every January.
Limited Powers (Please initial)
___________I hereby specifically and instruct my proxy to cast my ballot as authorized in Article II. Section F and
Article III. Section G of the COPPER HILL FOUR HOMEOWNER'S ASSOCIATION, INC., bylaws in refrence to the
following matter.
Annual Election of Board Members
The undersigned ratifies and confirms any acts and things that the proxy may do or cause to be done on the premises,
wether at the meeting referred to above or at any changes, adjournment, or continuation, and revoke all prior proxies
previously executed.
Dated:______________________
Lot Owner Name: (Printed)_______________________________________
Lot Owner Name: (Signature)_____________________________________
Lot Address:__________________________________________________
This Proxy Form is Void after: