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