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11 <br /> <br />AUTHORIZATION TO APPEAR ON BEHALF OF A PARTY <br /> <br />(Please Type Or Print the Requested Information) <br /> <br />SIGNATURES MUST BE IN BLUE INK <br /> <br />I <br />(person’s name) (title, if applicable) <br /> <br />of __ (name of company, association, organization, etc. if applicable) <br /> <br />hereby delegate to , <br />(person or entity’s name) <br /> <br />the right to appear on behalf of at the Pre-hearing conference. <br /> ( company, association, organization, etc.) <br /> <br /> <br /> <br />SIGNED AND DATED THIS DAY OF , . <br /> <br /> If corporate attest (seal) <br />Authorized Signature (must be signed in blue ink) <br /> <br />Title: <br /> <br />State of ) <br /> ) <br />County of ) <br /> <br />The forgoing instrument was acknowledged before me this day of , <br /> by as of . <br /> <br /> Notary Public <br />My commission expires: <br /> <br /> <br /> <br />SIGNATURE MUST BE IN BLUE INK