This downloadable form is a PDF file.

Special Power of Attorney

I, (1), of __(2), hereby appoint __(3)____ of __(4)___, as my attorney in fact to act in my capacity to do any and all of the following:

(DESCRIBE THE EXTENT OF AUTHORITY YOU ARE GIVING TO YOUR 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on ____(5)_, 19(6), and shall remain in full force and effect until ____(7)_____ or unless specifically extended or rescinded earlier by either party.

Dated _(8)__, 19(9)_. ____(10)__

STATE OF ___(11)____

COUNTY OF __(12)____

BEFORE ME, the undersigned authority, on this (13) day of (14)____, 19(15), personally appeared ____(16)___ 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. _(17)___

NOTARY PUBLIC

My Commission Expires:(18)__

Notice: This legal form is provided for general informational purposes. Before you utilize any legal form you find on the Internet, you should have it reviewed by a lawyer in your jurisdiction to be sure that it meets your legal needs, and will be held valid by a court in the jurisdiction where you reside.