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_SETUP.1
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20132.BLD
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1997-07-22
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#606
@001 Enter the name of the principal:
~Enter the name of the principal (person giving the right to
~sign checks to another.)
@002 Enter the name of the attorney:
~Enter the name of the attorney (person who is acting for the
~other). The term "attorney" does not infer that the person must
~be an attorney at law.
@003 Enter the name of the bank:
~Enter the name of the bank.
@004 Enter the account number:
~Enter the account number.
@005 Enter expiration date of power:
~Enter the date when the power of attorney will expire.
#end control section
#606
SPECIAL POWER OF ATTORNEY - SIGN CHECKS
@001, referred to as PRINCIPAL, appoints @002, referred to as
ATTORNEY, to be my lawful Attorney for me and in my place, to
ask, demand, levy, require, and to sign and endorse checks,
drafts, bills and notes in my name and in my stead and to be a
lawful signatory on any account in my name in any bank or trust
company including but not limited to my account at @003, account
@004 and to conduct such other banking transactions as may be
possible under the rules of any such bank. The expiration date
for this power shall be @005.
Dated: ________________________
________________________________
@001
Sworn to and subscribed before me on ____________________.
_______________________________
Notary Public
My commission expires: _______________