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When Recorded Mail To: ________________________ ________________________ ________________________ KNOW ALL MEN BY THESE PRESENTS, that I, _________________ [name], of __________________________ [address], State of ______________________, nominate _________________________ [name], residing at _____________________ [street address], City of _________________, constitute, and appoint ____________________ [name], residing at _____________________ [street address], City of __________________, County of ______________________, State of __________________________, my true and lawful attorney in fact, for me and in my name, place, and stead, and for my use and benefit; To ask, demand, sue for , recover, collect, and receive all sums of money, debts, dues, accounts, legacies, bequests, interest, dividends, annuities, and demands of every type that are now or may later become due, owing, payable or belonging to me and have, use, and take all lawful ways and means in my name or otherwise for the recovery thereof, by attachments, arrest, distress, or otherwise, and to compromise and agree for them and acquittances or other sufficient discharges for them; For me and in my name, to make, seal, and deliver, to bargain, contract, agree for, purchase, receive, and take lands, and tenements, hereditaments, and accept the possession of all lands, and all deeds and other assurances, in the law therefor, and to lease, let, demise, bargain, sell, release, convey, mortgage, and hypothecate lands, tenements, and hereditaments on the terms and conditions and under the covenants as [he] [she] thinks fit; Also to bargain and agree for, buy, sell, mortgage, hypothecate, and in any and every way and manner deal in and with goods, wares, and merchandise, choses in action, and other property in possession or in action, and to make, do, and transact all and every kind of business of every nature and kind; And also for me and in my name, and as my act and deed, to sign, seal, execute, deliver, and acknowledge the deeds, leases, mortgages, hypothecations, contracts, charter, bills of lading, bills, bonds, notes, receipts, evidence or debt, releases and satisfaction of mortgage, judgments and other debts, and other instruments in writing of every kind and nature that may be necessary or proper in the premises; GIVING AND GRANTING to my attorney in fact full power and authority to do and person every act necessary, requisite, or proper to be done as fully as I might or could do if personally present, with full power of substitution and revocation, hereby ratifying and confirming all that my attorney in fact may lawfully do or cause to be done by virtue of this power of attorney. All power and authority granted in this power of attorney will automatically terminate on [(date)] unless sooner revoked by me. IN WITNESS WHEREOF, I have signed my name to this power of attorney on ________________ __, ____. Signature Printed Name ACKNOWLEDGMENT State of ___________________ County of _________________ On _______________ __, ____, before me, ________________________ [name and title of person taking acknowledgment], personally appeared ________________________ [name(s) of person(s) signing instrument], personally known to me or proved to me on the basis of satisfactory evidence to be the person[s] whose name[s] _______________ [is or are] subscribed to the within instrument and acknowledged to me that [he or she or they] executed the same in [his or her or their] authorized [capacity or capacities], and that by [his or her ortheir] signature[s] on the instrument the person[s], or the entity upon behalf of which the person[s] acted, executed the instrument. WITNESS my hand and official seal. Signature [Seal]
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