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CSD 411B [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.#:XXX-XX- Debtor. BANKRUPTCY NO. SPECIAL 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 [ 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. 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 411B American LegalNet, Inc. www.FormsWorkFlow.com