o
|
Preliminary
Proxy Statement
|
o
|
Confidential,
for use of the Commission Only (as permitted by Rule
14a-6(e)(2))
|
x
|
Definitive
Proxy Statement
|
o
|
Definitive
Additional Materials
|
o
|
Soliciting
Material Pursuant to Rule 14a-12
|
x
|
No
fee required.
|
o
|
Fee
computed on table below per Exchange Act Rules 14a-6(i)(1) and
0-11.
|
(1)
|
Title
of each class of securities to which transaction
applies:
|
(2)
|
Aggregate
number of securities to which transaction
applies:
|
(3)
|
Per
unit price or other underlying value of transaction computed pursuant to
Exchange Act Rule 0-11 (Set forth the amount on which the filing fee is
calculated and state how it was
determined):
|
(4)
|
Proposed
maximum aggregate value of
transaction:
|
(5)
|
Total
fee paid:
|
o
|
Fee
paid previously with preliminary
materials.
|
o
|
Check
box if any part of the fee is offset as provided by Exchange Act Rule
240.0-11 and identify the filing for which the offsetting fee was paid
previously. Identify the previous filing by registration
statement number, or the Form or Schedule and the date of its
filing.
|
|
(1)
|
Amount
Previously Paid:
|
|
(2)
|
Form,
Schedule or Registration Statement
No.:
|
|
(3)
|
Filing
Party:
|
|
(4)
|
Date
Filed:
|
|
1.
|
Elect
the eight directors named in the attached Proxy Statement to serve until
the next annual meeting of shareholders or until their successors are
elected and qualified.
|
|
2.
|
Adopt
an amendment to the 2002 Stock Incentive Plan to increase the number of
shares reserved under the Plan from 4,600,000 to
6,100,000.
|
|
3.
|
Ratify
and approve the appointment of GHP Horwath, P.C. as our independent
registered public accounting firm.
|
|
4.
|
Transact
such other business as may lawfully come before the Meeting or any
adjournment(s) thereof.
|
Name
and Address of Beneficial
Owner
|
Position
|
Amount
and Nature of Beneficial Ownership
|
Percent
of
Class
|
Daryl
J. Faulkner (1)
1585
Perry Street
Castle
Rock, CO 80101
|
Chief
Executive Officer, Executive Chairman, and Director
|
10,000
|
*
|
Gregory
Pusey (2)
1585
Perry Street
Castle
Rock, CO 80101
|
Vice
Chairman, Secretary and Director
|
1,519,388
|
4.7%
|
Gail
S. Schoettler (3)
1585
Perry Street
Castle
Rock, CO 80101
|
Lead
Director
|
365,000
|
1.1%
|
Douglas
I. Hepler (4)
1585
Perry Street
Castle
Rock, CO 8010
|
Director
|
319,000
|
1.0%
|
David
E. Welch (5)
1585
S. Perry Street
Castle
Rock, CO 80104
|
Director
|
250,000
|
*
|
Mark
J. Ratain, MD. (6)
1585
S. Perry Street
Castle
Rock, CO 80104
|
Director
|
22,104
|
*
|
Michael
R. Merson (7)
1585
S. Perry Street
Castle
Rock, CO 80104
|
Director
|
27,291
|
*
|
John
H. Landon (8)
1585
S. Perry Street
Castle
Rock, CO 80104
|
Director
|
--
|
*
|
Robert
Caspari, MD (9)
1585
S. Perry Street
Castle
Rock, CO 80104
|
Chief
Operating Officer / Chief Medical Officer
|
3,200
|
*
|
Jeffrey
G. McGonegal (10)
1585
S. Perry Street
Castle
Rock, CO 80104
|
Chief
Financial Officer
|
592,322
|
1.8%
|
Mark
Colgin, PhD (11)
1585
S. Perry Street
Castle
Rock, CO 80104
|
Chief
Scientific Officer
|
505,408
|
1.6%
|
Richard
G. Donnelly (12)
2838
Garrett Drive
Fort
Collins, CO 80526
|
Former
Chief Executive Officer and Former President
|
988,115
|
3.0%
|
All
Directors and Executive Officers as a Group (12
persons)
|
4,601,828
|
14.2%
|
(1)
|
Includes
10,000 shares held in the Daryl J. and Teri L. Faulkner Family
Trust. Does not include options to acquire 500,000 shares at
$1.69 per share which are scheduled to vest annually over three years
commencing in January 2010.
|
(2)
|
Includes
626,341 shares directly owned by Mr. Pusey. Also, includes
137,290 shares held by Mr. Pusey’s wife, his wife's IRA account and their
daughter, however Mr. Pusey disclaims beneficial ownership of these
shares. Also includes: (i) 57,913 shares held in Mr. Pusey's IRA account,
(ii) 5,107 shares held jointly with his wife and (iii) 292,737 shares held
by Cambridge Holdings Ltd. Mr. Pusey is President, a director and
principal shareholder of Cambridge. Further, Mr. Pusey’s
beneficial ownership includes options to acquire 100,000 shares at $1.21
per share, options to acquire 250,000 options at $0.80 per share, options
to acquire 33,333 shares at $2.96 per share and options to acquire 16,667
shares at $6.63 per share. Excludes 16,667 options at $2.96 per share
which vest in January 2010, options to acquire 33,333 shares at $6.63 per
share, which vest equally in January 2010 and 2011 and also excludes
options to acquire 50,000 shares that were granted in January 2009 at
$1.33 per share which vest annually over three years commencing in January
2010.
|
(3)
|
Includes
15,000 shares directly owned. Also includes options to purchase 100,000
shares at $1.47 per share, options to purchase 50,000 shares at $.85 per
share, options to purchase 100,000 shares at $.96 per share, options to
purchase 50,000 shares at $1.60 per share, options to purchase 33,333
shares at $2.96 per share, and options to purchase 16,667 shares at $6.63
per share. Excludes options to purchase 16,667 shares at $2.96
per share which vest in January 2010, options to purchase 33,333 shares at
$6.63 per share which vest equally in January 2010 and 2011, and options
to purchase 50,000 shares at $1.33 per share which vest annually over
three years commencing in January 2010.
|
(4)
|
Includes
5,000 shares directly owned plus 14,000 shares held by Dr. Hepler's wife.
Dr. Hepler disclaims ownership of the shares held by his wife. Also
includes options to purchase 100,000 shares at $1.50 per share, options to
purchase 50,000 shares at $.80 per share, options to purchase 50,000
shares at $ 1.60 per share, options to purchase 33,333 shares at $2.96 per
share, options to purchase 16,667 shares at $6.63 per share. Also includes
options to purchase 50,000 shares at $.75 per share held by Dr. Helper's
wife, however Dr. Helper disclaims ownership of these shares. Excludes
options to purchase 16,667 shares at $2.96 per share as such options vest
in January 2010, options to purchase 33,333 shares at $6.63 per share
which vest equally in January 2010 and 2011, and options to purchase
50,000 shares at $1.33 per share which vest annually over three years
commencing in January 2010.
|
(5)
|
Includes
options to acquire 100,000 shares at $.76 per share, options to acquire
50,000 shares at $.80 per share, options to acquire 50,000 shares at $1.60
per share, options to acquire 33,333 shares at $2.96 per share and options
to purchase 16,667 shares at $6.63 per share. Excludes options to purchase
16,667 shares at $2.96 per share which vest in January 2010, options to
purchase 33,333 shares at $6.63 per share which vest equally in January
2010 and 2011 and options to purchase 50,000 shares at $1.33 per share
which vest annually over three years commencing in January
2010.
|
(6)
|
Includes
options to acquire 22,104 shares at $6.13 per share. Excludes options to
purchase 41,209 shares at $6.13 per share which vest equally in March 2010
and 2011, and options to purchase 50,000 shares at $1.33 per share which
vest annually over three years commencing in January 2010.
|
(7)
|
Includes
5,400 shares held directly. Also includes options to purchase
21,891 shares at $6.38 per share. Excludes options to purchase
43,783 shares at $6.38 per share which vest equally in July 2010 and July
2011, and options to purchase 50,000 shares at $1.33 per share which vest
annually over three years commencing in January 2010.
|
(8)
|
Mr.
Landon has assigned his option rights to a trust for which Mr. Landon
serves as the trustee. Excludes options to purchase 67,035
shares at $5.87 per share which vest annually over three years commencing
in December 2009 and options to purchase 50,000 shares at $1.33 per share
which vest annually over three years commencing in January
2010.
|
(9)
|
Includes
3,200 shares held directly. Excludes options to acquire 300,000
shares at $1.80 per share which are scheduled to vest annually over three
years commencing in February 2010.
|
(10)
|
Includes
194,156 shares held directly and 1,500 shares owned by his daughter. Also
includes options to purchase 60,000 shares at $1.47, options to acquire
140,000 shares at $1.21 per share, options to purchase 100,000 shares at
$.75 per share, options to purchase 50,000 shares at $.80 per share,
options to purchase 33,333 shares at $2.96 per share, and options to
purchase 13,333 shares at $6.63 per share. Excludes options to purchase
16,667 shares at $2.96 per share vesting in January 2010, options to
purchase 26,667 shares at $6.63 per share equally in January 2010 and
2011, and options to purchase 50,000 shares at $1.33 per share which vest
annually over three years commencing in January 2010.
|
(11)
|
Includes
472,075 shares held directly. Also includes options to purchase 33,333
shares at $2.96 per share. Excludes options to purchase 16,667 shares at
$2.96 per share vesting in January 2010, and options to purchase 50,000
shares at $1.33 per share which vest annually over three years commencing
in January 2010.
|
(12)
|
Mr.
Donnelly resigned as a Company officer and director in February
2009. Includes 824,681 shares held directly, 5,000 shares
held by his IRA and options to acquire 75,000 shares at $1.40 per share,
options to acquire 66,667 shares at $2.96 per share, and options to
acquire 16,667 shares at $6.63 per
share.
|
Name
and Address of
Beneficial Owner
|
Amount
and Nature of
Beneficial Ownership
|
Percent
of
Common Stock
|
RMB
Capital Management, LLC
115
S. LaSalle St., 34th
Floor
Chicago,
IL 60603
|
2,277,081
|
7.1%
|
The
Peierls Foundation, Inc.
c/o
U.S. Trust Company of N.Y.
114
West 47th
Street
New
York, N.Y. 10036
|
2,771,339
|
8.6%
|
Marathon
Capital Management
600
Lexington Avenue, Suite 1400
New
York, NY 10022
|
1,622,200
|
5.0%
|
Name
|
Age
|
Position
|
||
Daryl
J.
Faulkner
|
60
|
Chief
Executive Officer, Executive Chairman, and Director
|
||
Gregory
Pusey
|
57
|
Vice
Chairman, Secretary and Director
|
||
Gail
S.
Schoettler
|
65
|
Lead
Director
|
||
Douglas
I.
Hepler
|
62
|
Director
|
||
David
E.
Welch
|
62
|
Director
|
||
Mark
J. Ratain,
M.D.
|
54
|
Director
|
||
Michael
R.
Merson
|
65
|
Director
|
||
John
H.
Landon
|
69
|
Director
|
||
Robert
Caspari,
M.D.
|
63
|
Chief
Operating Officer / Chief Medical Officer
|
||
Jeffrey
G.
McGonegal
|
58
|
Chief
Financial Officer
|
||
Mark
Colgin Ph.D.
|
41
|
Chief
Scientific Officer
|
·
|
reviewed
and discussed the audited financial statements with management and the
independent accountants;
|
·
|
approved
the appointment of the independent
accountants;
|
·
|
discussed
with the independent accountants the matters required to be discussed by
SAS 61 (Codification of Statements on Auditing Standards, AU section
380), as modified by SAS 89 and SAS 90;
and
|
·
|
received
the written disclosures and the letter from the independent accountants
required by the applicable requirements of the Public Company Accounting
Oversight Board regarding the independent accountant’s communications with
the Audit Committee concerning independence, and discussed with the
independent accountant the accountant’s
independence.
|
·
|
reviewed
and discussed with management the Compensation Discussion and Analysis
disclosure; and
|
·
|
based
on such review and discussion, we recommended to the Board of Directors
that the Compensation Discussion and Analysis be included in this Proxy
Statement.
|
•
|
provide
a competitive total executive compensation package that enables us to
attract, motivate and retain key executives;
|
|
•
|
integrate
the compensation arrangements with our annual and long-term business
objectives and strategy, and focus executives on the fulfillment of these
objectives; and
|
|
•
|
provide
variable compensation opportunities that are directly linked with our
financial and strategic
performance.
|
•
|
base
salary;
|
|
•
|
annual
incentive awards;
|
|
•
|
long-term
equity awards; and
|
|
•
|
other
benefits.
|
Name
and
Principal
Position
|
Year
|
Salary
($)
|
Bonus
($)
|
Stock
Awards
($)(6)
|
Option
Awards
($)
(6)
|
Non-Equity
Incentive
Plan Compensation
($)
|
Non-Qualified
Deferred
Plan Compensation
($)
|
All
Other Compensa-tion
($)
|
Total
($)
|
|||||||||||||||
Daryl
J. Faulkner,
|
2008
|
$
|
—
|
$
|
—
|
$
|
—
|
$
|
—
|
$
|
—
|
$
|
—
|
$
|
—
|
$
|
—
|
|||||||
Chairman and
Interim Chief Executive Officer (1)
|
||||||||||||||||||||||||
Richard
G. Donnelly,
|
2008
|
$
|
250,000
|
$
|
37,500
|
$
|
—
|
$
|
140,719
|
$
|
—
|
$
|
—
|
$
|
30,946
|
$
|
459,165
|
|||||||
Former
- Chief Executive Officer and Director (2)
|
2007
|
$
|
222,917
|
$
|
280,000
|
$
|
74,000
|
$
|
78,981
|
$
|
—
|
$
|
—
|
$
|
31,784
|
$
|
687,682
|
|||||||
Jeffrey
G. McGonegal,
|
2008
|
$
|
110,000
|
$
|
—
|
$
|
—
|
$
|
89,086
|
$
|
—
|
$
|
—
|
$
|
20,613
|
$
|
219,699
|
|||||||
Chief
Financial Officer (3)
|
2007
|
$
|
100,000
|
$
|
80,000
|
$
|
—
|
$
|
35,889
|
$
|
—
|
$
|
—
|
$
|
20,857
|
$
|
236,746
|
|||||||
Dr.
Mark A. Colgin,
|
2008
|
$
|
125,000
|
$
|
26,600
|
$
|
—
|
$
|
26,333
|
$
|
—
|
$
|
—
|
$
|
12,417
|
$
|
190,350
|
|||||||
Chief
Scientific Officer (4)
|
2007
|
105,000
|
$
|
60,000
|
$
|
—
|
$
|
26,333
|
$
|
—
|
$
|
—
|
$
|
12,378
|
203,711
|
|||||||||
Dr.
Donald L. Traul
|
2008
|
$
|
105,000
|
$
|
15,000
|
$
|
—
|
$
|
15,800
|
$
|
—
|
$
|
—
|
$
|
9,078
|
$
|
144,878
|
|||||||
Manager-Scientific
Projects (5)
|
2007
|
$
|
90,000
|
$
|
40,000
|
$
|
—
|
$
|
91,503
|
$
|
—
|
$
|
—
|
$
|
8,175
|
$
|
229,678
|
|||||||
(1)
|
Mr.
Faulkner joined the Company on January 26, 2009 as Chairman of the Board
under an employment contract for an annual salary of $250,000. On that
date, he was granted 500,000 options at $1.69 per share vesting in arrears
over a three year period and expiring in ten years. Effective February 10,
2009, Mr. Daryl Faulkner was appointed as the interim Chief Executive
Officer.
|
(2)
|
Mr.
Donnelly served on the Company’s board of directors during fiscal 2007 and
2008 but did not receive separate compensation for serving as a director.
On February 10, 2009 Mr. Donnelly’s employment agreement terminated and he
resigned from his positions as President, Chief Executive Officer and as a
board member, positions that he had held since 2005. In January 2007 Mr.
Donnelly’s Employment Agreement was amended to among other to things
increase his annual compensation to $225,000 and he was also granted
25,000 restricted shares of common stock, valued at the time of issuance
at $74,000. In January 2008 Mr. Donnelly’s employment agreement was
amended to among other things increase his annual compensation to
$250,000. During 2008 and 2007 Mr. Donnelly was provided: temporary living
accommodations at a total cost of $11,045 and $10,917, respectively;
coverage under the Company’s group medical plan at a total cost of $14,743
and $16,016, respectively; and $4,851 in life insurance premiums during
each year. Mr. Donnelly was awarded a cash bonus for 2008 year of $37,500
that was paid to him in 2009 and a cash bonus for 2007 of $280,000 that
was paid to him in 2008. On January 24, 2007 Mr. Donnelly was granted
100,000 options at $2.96 per share vesting in arrears over a three year
period and expiring in ten years. On January 17, 2008 Mr. Donnelly was
granted 50,000 options at $6.63 per share vesting in arrears over a three
year period and expiring in ten years from the date of grant. Subsequent
to December 31, 2008, on January 27, 2009, Mr. Donnelly was granted
50,000 options at $1.69 per share which were to vest in arrears over a
three year period and expiring in ten years from the date of
grant.
|
(3)
|
Effective
February 10, 2009 the Company commenced an employment agreement with
Jeffrey McGonegal, the Company’s chief financial officer. Mr. McGonegal
has served as the Company’s chief financial officer since 2003, and was
paid an annual salary of $110,000 in 2008. The employment
agreement, effective as of February 10, 2009, is for an initial one year
term and will automatically renew for successive one year terms unless
terminated by either party. Mr. McGonegal currently devotes substantial
but not all of his business related time to the
Company. Effective February 10, 2009 Mr. McGonegal began
receiving annual salary of $175,000 which amount will be increased to
$225,000 effective upon Mr. McGonegal devoting all of his business related
time to the Company. Mr. McGonegal was awarded with a cash bonus for the
2007 year of $80,000 that was paid to him in 2008. Mr. McGonegal was
provided coverage under the Company’s group medical plan during 2008 and
2007 at a total cost of $20,613 and $20,857, respectively. During 2007 Mr.
McGonegal was granted options to acquire 50,000 shares of common stock at
$2.96 per share vesting in arrears over a three year period and expiring
in ten years. In January 2008, he was granted 40,000 options at $6.63 per
share vesting in arrears over a three year period (being January 17, 2009,
2010 and 2011) and expiring in ten years from the date of grant.
Subsequent to December 31, 2008, on January 27, 2009 Mr. McGonegal was
awarded 50,000 options at $1.69 per share vesting in arrears over a three
year period (being January 27, 2009, 2010 and 2011) and expiring in ten
years from the date of grant.
|
(4)
|
During
2008, Dr. Colgin’s annual compensation was $125,000 and he was awarded a
cash bonus for 2008 of $26,600 which was paid in 2009. On February 10,
2009, Dr. Colgin was promoted to the position of Chief Scientific Officer
and his annual compensation was increased to $150,000. During 2007, Dr.
Colgin was paid an annual salary of $105,000 and he received a cash bonus
of $60,000, which was paid in 2008. During 2008 and 2007 Dr. Colgin was
also provided coverage under the Company’s group medical plan at a total
cost of $12,097 and $12,058, respectively and $320 in life insurance
premiums during each year. Subsequent to December 31, 2008, on January 27,
2009 Dr. Colgin was awarded 50,000 options at $1.69 per share vesting in
arrears over a three year period (being January 27, 2009, 2010 and 2011)
and expiring in ten years from the date of
grant.
|
(5)
|
Although
we do not consider Dr. Traul to be an “officer” of the Company as defined
in Rule 16a-1 promulgated under the Securities Exchange Act of 1934, Dr.
Traul is one of the Company’s most highly compensated employees. During
2008, Dr. Traul’s annual compensation was $105,000 and he received a cash
bonus for 2008 of $15,000 which was paid in 2009. During 2007, Dr. Traul
was paid an annual salary of $90,000 and he received a cash bonus for 2007
of $40,000, which was paid in 2008. During 2008 and 2007 he was also
provided coverage under the Company’s group medical plan at a total cost
of $9,078 and $8,175, respectively. Subsequent to December 31, 2008, on
January 27, 2009 Dr. Traul was awarded 30,000 options at $1.69 per share
vesting in arrears over a three year period (being January 27, 2009, 2010
and 2011) and expiring in ten years from the date of
grant.
|
(6)
|
The
Company values common shares issued for compensation at the closing
trading price on the day of award. Options and warrants issued for
compensation are valued based the Black-Scholes model using the assumption
as detailed in the notes to the Company’s financial statements filed on
Form 10-K.
|
Name
and Principal Position
|
Number
of
Securities
Underlying
Exercisable
Options
(#)
(1)
|
Number
of
Securities
Underlying
Un-exercisable
Options
(#)
|
Equity
Incentive
Plan
Awards:
Number
of
Securities
Underlying
Unexercised
Unearned
Options
|
Option
Exercise
Price
($)
|
Option Expiration
Date
|
|||||||
Daryl
J. Faulkner,
|
—
|
—
|
||||||||||
Chairman and Interim Chief
Executive Officer
|
||||||||||||
Richard
G. Donnelly,
|
500,000
|
—
|
—
|
$0.60
|
1-24-15
|
|||||||
Former - Chief Executive
Officer, President
|
75,000
|
—
|
—
|
$1.40
|
1-24-16
|
|||||||
and
Director
|
66,667
|
33,333
|
—
|
$2.96
|
1-24-17
|
|||||||
16,667
|
33,333
|
—
|
$6.63
|
1-17-18
|
||||||||
Jeffery
McGonegal,
|
60,000
|
—
|
—
|
$1.47
|
6-17-13
|
|||||||
Chief Financial
Officer
|
140,000
|
—
|
—
|
$1.21
|
1-19-14
|
|||||||
100,000
|
—
|
—
|
$0.75
|
8-24-14
|
||||||||
50,000
|
—
|
—
|
$0.80
|
3-24-15
|
||||||||
33,333
|
16,667
|
—
|
$2.96
|
1-24-17
|
||||||||
13,333
|
26,666
|
—
|
$6.63
|
1-17-18
|
||||||||
Dr.
Mark A. Colgin,
|
33,333
|
16,667
|
—
|
$2.96
|
11-21-16
|
|||||||
Chief Scientific
Officer
|
||||||||||||
Dr.
Donald L. Traul,
|
10,000
|
10,000
|
—
|
$1.97
|
11-21-16
|
|||||||
Manager
of Scientific Projects
|
Name
|
Fees
Earned or
Paid
in
Cash ($)
|
Stock
Awards
($)
|
Option
Awards
($)
|
Non-Equity
Incentive
Plan
Compensation
|
All
Other
Compensation
|
Total
|
||||||||||||||
Gregory
Pusey (1)
|
$
|
150,000
|
—
|
$
|
101,569
|
—
|
—
|
$
|
260,889
|
|||||||||||
Director
|
||||||||||||||||||||
Gail
Schoettler (2)
|
$
|
11,500
|
—
|
$
|
124,786
|
—
|
—
|
$
|
136,286
|
|||||||||||
Lead
Director
|
||||||||||||||||||||
Douglas
Hepler (3)
|
$
|
11,500
|
—
|
$
|
124,786
|
—
|
$
|
52,900
|
$
|
189,186
|
||||||||||
Director
|
||||||||||||||||||||
David
Welch (4)
|
$
|
11,500
|
—
|
$
|
124,786
|
—
|
—
|
$
|
136,286
|
|||||||||||
Director
|
||||||||||||||||||||
Dr.
Mark Ratain (5)
|
$
|
10,000
|
—
|
$
|
59,781
|
—
|
$
|
35,000
|
$
|
104,781
|
||||||||||
Director
|
||||||||||||||||||||
Michael
R. Merson (6)
|
$
|
7,000
|
—
|
$
|
41,681
|
—
|
—
|
$
|
48,681
|
|||||||||||
Director
|
||||||||||||||||||||
John
H. Landon (7)
|
$
|
—
|
—
|
$
|
3,224
|
—
|
—
|
$
|
3,224
|
|||||||||||
Director
|
Name and Position
|
Number of Options
|
Daryl
J. Faulkner -
Chief
Executive Officer, Executive Chairman and Director
|
500,000
|
Jeffrey
McGonegal – Chief Financial Officer
|
490,000
|
Mark
Colgin – Chief Scientific Officer
|
100,000
|
Current
Other Executives as a Group
|
850,000
|
Non-Executive
Director Group
|
1,499,022
|
Non-Executive
Employee and Consultant Group
|
1,057,510
|
Daryl J. Faulkner | For o | Withhold Authority to vote o | |
Gregory Pusey | For o | Withhold Authority to vote o | |
Gail S. Schoettler |
For
o
|
Withhold Authority to vote o | |
Douglas I. Hepler | For o | Withhold Authority to vote o | |
David E. Welch | For o | Withhold Authority to vote o | |
Mark J. Ratain | For o | Withhold Authority to vote o | |
Michael R. Merson | For o | Withhold Authority to vote o | |
John H. Landon | For o | Withhold Authority to vote o | |
_____________________________________
Signature(s)
Address
if different from that on envelope:
_____________________________________
Street
Address
_____________________________________
City,
State and Zip Code |
|