Power of Attorney



Power of Attorney (general form)



I, _____________, residing at ____________ hereby grant this Power of Attorney to ________________ located at ________________ ("Attorney-in-fact").

My Attorney-in-fact shall have full powers and authority to do and undertake the following on my behalf: ___________________________
(submit fiduciary duties)

Any powers not specifically mentioned herein shall not be given. My Attorney-in-fact hereby accepts this appointment and agrees to perform said fiduciary duties (specify with or without pay) in a competent fashion, with my best interests always in mind.

(State if and how the Power-of-attorney can be revoked)
(for example, "This Power of attorney can be revoked by me at any time for any reason upon written notice").

This formal Power of attorney supersedes and replaces all prior agreements and understandings, whether oral or in writing, and may only be modified in a separate writing signed by both Parties.

IN WITNESS WHEREOF, I sign this Power of Attorney on the date below written. 

<____> (Sign of Person Granting Power of Attorney)

Dated: ____________



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