

(Member: Insert name of proxy holder–the person you are authorizing to vote in your place–in first paragraph, then date, sign and return by the date indicated to LLC officer at address listed below.)
The undersigned member of XXX, a limited liability company, authorizes XXX to act as his or her proxy and to represent and vote his/her LLC membership at a meeting of:
(Check one or both boxes)
[ ] managers
[ ] members
to be held on XXX.
This proxy shall be effective for all items of business brought before the meeting.