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Bankruptcy Proceedings Representation

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This is a form which authorizes a third party to appear on behalf of a debtor in bankruptcy proceedings. By executing this form, the debtor authorizes the third party to vote on their behalf at any creditor meeting. Additionally, the third party will obtain authorization to accept payments and dividends on behalf of the debtor. This form should be used by an entity or individual who wants to authorize a third party to act on their behalf in a bankruptcy proceeding.

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									This is a form which authorizes a third party to appear on behalf of a debtor in
bankruptcy proceedings. By executing this form, the debtor authorizes the third party to
vote on their behalf at any creditor meeting. Additionally, the third party will obtain
authorization to accept payments and dividends on behalf of the debtor. This form
should be used by an entity or individual who wants to authorize a third party to act on
their behalf in a bankruptcy proceeding.
                                                       Bankruptcy Proceedings Representation


        BANKRUPTCY PROCEEDINGS REPRESENTATION


TO:

RE:    Bankruptcy Proceedings Representation Notice



  THE UNDERSIGNED ________________ (the “Bankrupt”) hereby nominates and appoints
_______________________, located in the City of ________________, State of
_______________, to correspond and attend any meetings of the creditors of the Bankruptcy
which are named in the bankruptcy proceedings of the Bankrupt.

   THE BANKRUPT hereby further authorizes _________________________ to vote at any
meeting of the creditors of the Bankrupt in respect to any consumer proposal or decision which
may be submitted to any court relating to the bankruptcy proceedings of the Bankrupt and to do
any and all acts necessary for carry out any consumer proposal or decision made at any meeting
of creditors of the Bankrupt.

   THE APPOINTMENT OF ___________________ by the Bankrupt shall include
______________ acting as trustee of the Bankrupt and _______________ shall have the power
to accept the payment of any dividends or consideration which may be due and for any other
purposes whatsoever in relation to the bankruptcy proceedings of the Bankrupt.

  EXECUTED this ____ day of _____________, 2_____.




Witness:                                          Bankrupt                          Signature
                                                                                  Bankruptcy Proceedings Representation


								
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