General Power of Attorney (United States)
This is a General Power of Attorney supplemental form to a bankruptcy form. The form provided here is simply a sample of what the actual Form B11A looks like.
Form B11A
6/90
Form 11A. GENERAL POWER OF ATTORNEY
[Caption as in Form 16B]
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.