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General Power of Attorney (United States)

This is a general power of attorney. The form provided here is simply a sample of what the actual form looks like.


I, ________(1)__________, of ________(2)____________,

hereby appoint __________(3)____________, of _________(4)_____________, 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

_______(5)____________ or unless specifically extended or rescinded earlier by either party.

Dated _______(6)____________, ___(7)__.


STATE OF _________(9)___________

COUNTY OF ________(10)__________

BEFORE ME, the undersigned authority,

on this _(11)_ day of _______(12)_______, 20__(13)_, personally appeared

_____________(14)_______________ 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.


My Commission Expires:__(16)__

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