CSD 411A [12/01/18] Name, Address, Telephone No. & I.D. No. UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF CALIFORNIA 325 West F Street, San Diego, California 92101 - 6991 In Re Tax I.D.(EIN)#: /S.S.#: XX X - XX - Debtor . BANKRUPTCY NO. GENERAL POWER OF ATTORNEY To of (Attorney) and (Mailing Address) of (Attorney) (Mailing Address) 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 this 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 i n 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 .] CSD 411A American LegalNet, Inc. www.FormsWorkFlow.com