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AUTHORIZATION TO APPEAR AT PRE-HEARING CONFERENCE <br /> 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, <br /> organization, etc., if applicable) <br /> hereby delegate to <br /> (person or entity's name) <br /> the right to appear on behalf of <br /> (person, company, association, organization, etc.) <br /> at the Pre-hearing Conference. <br /> SIGNED AND DATED THIS DAY OF <br /> If corporate attest <br /> (seal) Authorized Signature (must be signed in blue ink) <br /> Title: <br /> State of ) <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 /> SIGNATURES MUST BE IN BLUE INK <br />