Official Form 11a - General Power Of Attorney printable pdf download

Official Form 11A

6/90

United States Bankruptcy Court

_______________ District Of _______________

In re _______________________,

Debtor

Case No. _____________

Chapter __________

GENERAL 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 and with

full power of substitution, to vote on any question that may be lawfully submitted to creditors of the debtor in the above-entitled

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 in 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.]

* State mailing address.

Official Form 11a - General Power Of Attorney