Nomination of Authorized Representative

In the event the Lead | Head | CEO of the member or the authorized representative as indicated on the member application form cannot attend the General Assembly, the Lead | Head | CEO shall appoint a representative to represent the member and vote on behalf of the member.

In the event the Lead | Head | CEO or the authorized representative as indicated on the member application form cannot attend the General Assembly and no representative has been appointed prior to the election day, the member will not have the right to vote.

Instructions:

  • Complete the Nomination of Authorized Representative Form online prior to the elections.
  • Saving a draft of this form to be finished, reviewed and/or submitted later is not supported. Make sure to have access to all information required in the form before starting to complete it.
  • Should you wish to make amendments after submission, complete and submit the form again. The last submission will be considered valid.

Nomination Deadline:

On or before 12:00 pm, Monday, April 4, 2022

I, the undersigned, in my quality of the Lead | Head | CEO of the member company mentioned below, wish to appoint a representative to represent the company at the IAB’s General Assembly and to vote on my and company’s behalf on April 6, 2022 and at any adjournment thereof.

Nomination of Authorized Representative

Authorized Representative

 

Authorization Given By

 

Signature*

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