UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF NEW YORK FORM TO BE COMPLETED BY THE CLIENT FOR WHOM THE LAW STUDENT IS RENDERING SERVICES; OR IF THE SERVICES ARE RENDERED FOR THE GOVERNMENT, BY THE UNITED STATES ATTORNEY OR HIS AUTHORIZED REPRESENTATIVE I authorize , a law student, to appear in court or at other proceedings on my behalf and to prepare documents on my behalf. I am aware that he/she is not admitted to the bar and that he/she will appear pursuant to the United States Bankruptcy Court, Western District of New York, Student Practice Rule. Dated: (Signature of Client) (If more than one client is involved, approvals from each shall be attached. If a class action is involved, approvals from named plaintiffs shall be attached.) TO BE COMPLETED BY THE LAW STUDENT’S SUPERVISING ATTORNEY: I will carefully supervise all of this student’s work. I authorize this student to appear in court or at other proceedings and to prepare documents. I will accompany the student at such appearances and sign all documents prepared by the student. I assume personal responsibility for his/her work. Dated: (Signature of Attorney) 2002 © American LegalNet, Inc.