POWER OF ATTORNEY

I ………………………………………………………. do hereby grant this Power of Attorney to ADVKIT PARA LEGAL SERVICES and/or its assigns.

This Power of Attorney grants to ADVKIT PARA LEGAL SERVICES and/or its assigns the right to act on my behalf for the purpose of establishing any entitlement or to dispute any entitlement that may or may not have been received by me or that I may have had or been entitled to receive from the Accident Compensation Corporation and/or its assigns.

Further this Power of Attorney grants to ADVKIT PARA LEGAL SERVICES the right to investigate or negotiate any settlement made or that may be made on my behalf between myself and the Accident Compensation Corporation and/or its assigns and this Power includes the right of inspection and/or the right to request the provision of all of my personal files and or documents electronic or otherwise that may be in the care of the Accident Compensation Corporation and/or its assigns in accordance with the provisions of the Privacy Act 1993.

This Power of Attorney rescinds any previous authorities granted by me in the name of any other party whatsoever but shall not displace any person previously authorized by me to act as an agent for the purpose of receiving any payments made by the Accident Compensation Corporation on my behalf.

This Power of Attorney is limited to those powers described above and do NOT empower ADVKIT PARA LEGAL SERVICES to receive any monies due to me from Accident Compensation Corporation and/or its assigns other than any costs that may be granted by way of Review hearing or District Court appeal.

This Power of Attorney shall remain in force until such time as I formally revoke the Powers granted by writing to both Accident Compensation Corporation and/or its assigns and to ADVKIT PARA LEGAL SERVICES with notice thereof.

Signed by me ……………………………………………

at …………………………………. on this ………. day of …………………….200 ...

It is requested that your office log the above document into Accident Compensation Corporation electronic information system and/or that of its assigns to enable the designated party(s) to make written or telephone enquiries related to my case management and/or file documents.