Official Form 11B
United States Bankruptcy Court
_______________ District Of _______________
In re _______________________,
Case No. _____________
SPECIAL 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 [if desired:
and with full power of substitution,] to attend the meeting of creditors of the debtor or any adjournment thereof, and to vote in
my behalf on any question that may be lawfully submitted to creditors at such meeting or adjourned meeting, and for a trustee or
trustees of the estate of the debtor.
[If executed by an individual] Acknowledged before me on __________________________.
[If executed on behalf of a partnership] Acknowledged before me ________________________________________,
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.
* State mailing address.