Laserfiche WebLink
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 F-Mdefickf f ? Char or wL-0 ? <br />(person's name) (title, if applicable) <br />lie b Axavudki ame f company, association, organization, etc. if applicable) <br />7 <br />of <br />i <br />hereby delegate to F&Y " 8 5 <br />(person or entity's Jame) <br />the right to appear on behalf o F? YoiV ate re-hearing conference. <br />( compan association, organization, etc.) <br />?d <br />SIGNED AND D TED THIS _ DAY OF P?Vak <br />If corporate attest (seal) <br />Authorized Signature (must be signed in blue ink) <br />Title: <br />1?-- 4,11 Z ow * -I,- - <br />The forgoing instrument was ac owledged before me this 9' day of <br />by rQ',?QTZI?p <br />otary Public <br />?My commission expires: -? ' 8" <br />State of <br />) <br />County of <br />SIGNATURE MUST BE IN BLUE INK <br />11