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AUTHORIZATION TO REPRESENT A PARTY <br />(Please Type Or Print The Requested Information) <br />SIGNATURES MUST BE IN BLUE INK <br />I <br />(person's name) (title) <br />of (name of company, association, organization, etc.) am <br />authorized to delegate <br />.a <br />(person's name) (consultant, etc.) <br />to represent (name of person, company, association, organization, <br />etc.) at the Pre-hearing Conference and/or Hearing before the Mined Land Reclamation Boazd in <br />this matter. <br />SIGNED AND DATED THIS DAY OF <br />If corporation attest (seal) <br />Authorized Signature (must be signed in blue ink) <br />Title: <br />State of ) <br />ss <br />County of ) <br />The foregoing instrument was aclmowledged before me this <br />by as <br />Notary Public <br />My commission expires: <br />SIGNATURES MUST BE IN BLUE INK <br />day of , <br />of <br />A:\blkdoc\pttywve.wp <br />