Form B11A 6/90
Form 11A. GENERAL POWER OF ATTORNEY [Caption as in Form 16B] GENERAL POWER OF ATTORNEY
To ________________________________________ of * ________________________________________, and _____________________________________________ of * __________________________________________________. The undersigned claimant hereby authorizes you, or any one of you, as attorney in fact for the undersigned and with full power of substitution, to vote on any question that may be lawfully submitted to creditors of the debtor in the aboveentitled case; [if appropriate] to vote for a trustee of the estate of the debtor and for a committee of creditors; to receive dividends; and in general to perform any act not constituting the practice of law for the undersigned in all matters arising in this case.
Dated: ___________________________
Signed: _______________________________________
By ___________________________________ as ____________________________________
Address:_______________________________________ _______________________________________________
[If executed by an individual] ______________________________________________.
Acknowledged
before
me
on
[If executed on behalf of a partnership] Acknowledged before me on _____________________________, by _________________________________________, who says that he [or she] is a member of the partnership named above and is authorized to execute this power of attorney in its behalf. [If executed on behalf of a corporation] Acknowledged before me on _____________________________, by _______________________________, who says that he [or she] is ___________________________ of the corporation named above and is authorized to execute this power of attorney in its behalf.
___________________________________________ ___________________________________________ [Official character.] * State mailing address.