f. Blue Cross Blue Shield proxy vote
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f. Blue Cross Blue Shield proxy vote
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<br />BlueCross BlueShield <br />of North Dakota <br /> <br />+, <br /> <br />An Independent licensee of the Blue Cross & Blue Shield Association <br /> <br />4510 13th Avenue South <br />Fargo, North Dakota 58121 <br /> <br />Ell <br /> <br />ATTN: M1 KE MONTPLA1 SI R 180000027380 <br />CASS COUNTY PERSONNEL <br />211 9TH ST S <br />FARGO ND 58103-1833 <br /> <br />1.11111..1....1111111'11111..111..11'111...11"1.1111111.11..1 <br /> <br />NOTICE OF ANNUAL MEETING <br />Please take notice that the Annual Meeting of Members of Noridian Mutual Insurance Company is scheduled <br />to take place at 9 a.m. on December 7, 2007, at the Blue Cross Blue Shield of North Dakota Home Office, <br />4510 13th Avenue South, Fargo, ND, for the purposes of electing members to the Board of Directors of the <br />Company and considering such other business as may properly come before the meeting. <br /> <br />You can cast a ballot or assign a proxy either by mail or online at www.BCBSND.com. For instructions on how <br />to complete a ballot or proxy, see the reverse side of this form. <br /> <br />Proxy forms must be received by December 3, 2007, to be valid. Please complete and sign either the proxy or <br />ballot side of the form attached below. Forms received with both sides completed and signed are void, as we <br />are unable to determine which option you intended. <br /> <br />SIGN ONLY ONE SIDE OF THIS CARD <br /> <br />Detach along perforation <br /> <br />FORM MUST BE RECEIVED BY DECEMBER 3, 2007 <br /> <br />I, the undersigned Voting Member of Noridian Mutual Insurance Company, hereby appoint Laura D. <br />Carley, Mark S. Sanford, Ed.D. and Mary K. Wakefield, Ph.D., R.N., each of them with power of <br />substitution, as my proxy to attend and vote on my behalf at the Annual Meeting of Members of the <br />Company to be held on December 7, 2007, or any adjournment thereof, upon the following matters: <br /> <br />(1) Re-election of Directors; <br />(2) On such other business as may properly come before the members. <br /> <br />User Key 7900349549 <br /> <br />ATTN: MIKE MONTPLAISIR <br />CASS COUNTY PERSONNEL <br />211 9TH ST S <br />FARGO ND 58103-1833 <br /> <br />day of <br /> <br />,2007 <br /> <br />Dated and signed this <br /> <br />MSJ540A_OJ. <br /> <br />7380 <br /> <br />Signature of Voting Member (SIGN ONLY ONE SIDE) <br /> <br />Norldlan Muluallnsurance Comoanv <br /> <br /> <br />JA()g1307?.NOSS <br />
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