Special Power of Attorney Form
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SPECIAL POWER OF ATTORNEY I, __________, of __________, hereby appoint __________ of __________, as my attorney in fact to act in my capacity to do any and all of the following: [Describe Specific Authority You Are Giving To Attorney-In-Fact] The rights, powers, and authority of my attorney in fact to exercise any and all of the rights and powers herein granted shall commence and be in full force and effect on __________, 20____, and shall remain in full force and effect until __________, 20____, or unless specifically extended or rescinded earlier by either party. Dated: __________, 20____ By: __________ STATE OF __________, COUNTY OF __________ [NOTARIZATION]
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[Last Revised 3/02]
