Pursuant to notice of meeting, dated _____, a special meeting of
shareholders of ____________. was held at __, ,
___ on _ at .
A quorum of shareholders attended, as shown by the attached roster. Proxies (if any)
were examined and admitted as shown by the attached roster.
The meeting was called to order by the meeting’s chairman, ___________.
The following actions were taken at this meeting:
__________________________________________________________….
There being no further business to come before the meeting the same was adjourned….
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