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AUTHORIZATION TO APPEAR ON BEHALF OF A PARTY <br />(please Type Or Print the Requested Information) <br />SIGNATIAM MUST BE IN BLUE INK <br />?Fo 4C e?No- <br />(perks name) (title, if applicable) <br />Of (name of company, association, organization, etc. if applicable) <br />hereby delegate to Lz are a A 11 44r o .e% ? Ci, <br />(person or entity's name) <br />the right to appear on behalf of PA 'w at the Pre-hearing conference. <br />( company, assoo' 'on, organization, etc.) <br />SIGNED AND DATED THIS 19 DAY OF l <br />If corporate attest (sorb) <br />Authoriz Signature (must be signed in blue ink) <br />Title: <br />State of e`?G bh ?1 'ti,.?. <br />County of Da 0 ?- 1 <br />The forgoing instrument was acknowledged before me this day of by J- ^19 5J-5Av as j of diye5??t5?>1 <br />otary Pu c ? -/3 <br />My commission expires: ': -, <br />SIGNATURE MUST BE IN BLUE INK <br />11