POWER OF ATTORNEY 

_______________, the "principal," of ________, ______, herewith
appoints _____________ of ________, ______, as their attorney in
fact, to act in the place and stead and with the same authority as
Principal would have to do the following acts: 

	To act for me in the regard to the following: 


_________________________________________________________________

This power of attorney shall be in effect from _______________ to
________________ and shall not be revoked due to my incapacty, and
will continue in effect should I ever become incapaitated. 



_____________________________________________________ 


STATE OF _________________ 

COUNTY OF ________________ 

_______________ personally appeared before me and acknowledged 
the execution of this power of attorney for the purposes set forth
therein. 



 Dated: _______________________________ 





__________________________________________ 
Notary Public