I, _____________________, of _______________________,
hereby appoint _________________________, of _________________________,
as my attorney in fact to act in my capacity to do
every act that I may legally do through an attorney
in fact. This power shall be in full force and effect
on the date below written and shall remain in full
force and effect until ______________________ or unless
specifically extended or rescinded earlier by either
party.
Dated ______________________, 20______.
______________________________
STATE OF _______________________
COUNTY OF ______________________
BEFORE ME, the undersigned authority, on this _____
day of __________________, 20____, personally appeared
__________________________ to me well known to be
the person described in and who signed the Foregoing,
and acknowledged to me that he executed the same freely
and voluntarily for the uses and purposes therein
expressed.
WITNESS my hand and official seal the date aforesaid.
_____________________________
NOTARY PUBLIC
My Commission Expires:________
NOTICE
The information in this document is designed to
provide an outline that you can follow when formulating
business or personal plans. Due to the variances of
many local, city, county and state laws, we recommend
that you seek professional legal counseling before
entering into any contract or agreement.
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