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POWER OF ATTORNEY
(TYPE 2)

By affixing my signature below I, _________________, residing at _______________, __________________________ make, constitute, and appoint, _________________,
residing at _______________________________________ my true and lawful attorney
in fact, for me and in my name and stead, and to my use, for the purpose of __________ __________________________________. 

I hereby give to my attorney full authority and power to do anything and everything whatsoever required or obligated to be done, at least to the extent I could or might do, with full power of substitution and revocation.  I hereby confirm and sanction all that said attorney shall lawfully do or cause to be done, acting on my behalf and in my stead.

 

Signed this _________ day of ______________________________.

 

__________________________________

 

__________________________________
Witness