SURROGATE'S COURT OF THE STATE OF NEW YORK COUNTY OF ___________________ STATEMENT OF AUTHORIZATION FOR ELECTRONIC FILING (Single Attorney Authorizing Individual Filing Agent) I, ________________________, Esq., ( Attorney Registration No. ______________ ) am an authorized user of the New York State Courts Electronic Filing System ("NYSCEF") (User ID ____________ ). I hereby authorize ________________________________________ ("the filing agent") to utilize his/her NYSCEF filing agent ID to file documents on my behalf and at my direction in any e-filed proceeding in which I am counsel of record through the NYSCEF system, as provided in Section 207.4-a of the Uniform Rules for the Trial Courts. This authorization extends to any consensual proceeding in which I have previously consented to e-filing, to any mandatory proceeding in which I have recorded my representation, and to any proceeding in which I may authorize the filing agent to record my consent or representation in the NYSCEF system. This authorization extends to any and all documents I generate and submit to the filing agent for filing in any such proceeding. This authorization, posted once on the NYSCEF website as to each proceeding in which I am counsel of record, shall be deemed to accompany any document filed in that proceeding by the filing agent. I further authorize the filing agent to view documents that I have filed or that I generate and submit to the filing agent for filing in any such proceeding. This authorization also extends to matters of payment, which the filing agent may make either by debiting an account the filing agent maintains with the Clerk of the Surrogate's Court in any authorized e-filing county or by debiting an account I maintain with the Clerk of the Surrogate's Court in any authorized e-filing county. This authorization regarding this filing agent shall continue until I revoke it in writing on a prescribed form delivered to the E-Filing Resource Center. Dated: ____________________ ___________________________ Signature ___________________________ Print Name ___________________________ City, State and Zip Code ___________________________ Phone American LegalNet, Inc. www.FormsWorkFlow.com ___________________________ Firm/Department ___________________________ Street Address ___________________________ E-Mail Address (3/19/12) American LegalNet, Inc. www.FormsWorkFlow.com