Arlington County Republican Committee Mark Kelly, Chairman

INSTRUCTIONS: Fill in the blanks on this form and print. Then sign and date the form, in the presence of a witness (other than your proxy), and have the witness sign. Then deliver the completed form to your proxy holder.

Official proxy

I of precinct
do hereby appoint of precinct to vote as my proxy at a meeting of the Arlington County Republican Committee
to be held at on , , with all the power I should possess if personally present, hereby revoking all previous proxies.

Signed:

_________________________________ on _____, .

(Committee member's signature)

Witnessed by:

_________________________________

(Witness' signature)

Please note:

  • Proxies are governed by the Arlington County Republican Party Plan (Art. III, Sec. 2(C)(2)).
  • No individual may cast more than one vote on any issue. Any proxy given to another current ACRC member will be invalid.
  • An ACRC member from a designated precinct may give his/her proxy only to a registered voter in that precinct.
  • An ACRC member “at large” may give his/her proxy to any registered voter who lives in Arlington.
  • Proxies given for previous meetings are no longer valid. You must execute a new proxy for each meeting.

If you have any questions regarding the proxy process, please contact ACRC.