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That I,__________________________ , an adult resident citizen of _______________ County, ____________ (State), residing at _______________________, _____________, _______________ have made, constituted and appointed, and by these presents do make, constitute and appoint, ___________________________ my true and lawful attorney to act as follows, that is to say:

1.         Disposition of Property.  To sell, assign, transfer, convey, exchange, deed, mortgage, pledge, lease, let, license, demise, remise, quitclaim, bargain or otherwise dispose of any or all of my real estate, stocks, bonds, evidences of indebtedness and other securities and other personal tangible and intangible or mixed property, or any custody, possession, interest or right therein at public or private sale, upon such terms, consideration, and conditions as my said attorney shall deem advisable and to execute, acknowledge and deliver such instruments and writings of whatsoever kind and nature as may be necessary, convenient or proper in the premises.

2.         Collection of Debts.  To demand, collect, recover, sue for, receive and give receipt or release for any monies, debts, dividends, interests, royalties, legacies, annuities, demands, discounts, income, rents, profits, securities or other property of any sort, now or hereafter due or becoming due to me or to which I may be or hereafter become entitled.

3.         Endorsements.

a)                  To endorse and negotiate for any and all purposes all promissory notes, bills of exchange, checks, drafts or other negotiable or non-negotiable paper payable to me or to my order;

b)                  To endorse for transfer all certificates of stock, bond or other securities;

c)         To endorse and cash United States Savings Bonds and notes.

4.         Depositing Money and Other Property.  To deposit in my attorney’s or my name, or jointly in both our names, in any banking institution, funds or property, and to withdraw any part or all of my deposits at any time made by me in my behalf.

5.         Acquisition of Property. To buy, receive, lease, accept or otherwise acquire in my name and for my account property, real, personal or mixed, upon such terms, considerations and conditions as my said attorney shall think proper.

6.         Recovering Possession of Property. To eject, remove or relieve tenants or other persons from, and recover possession of, any property, real, personal or mixed in which I now or hereafter may have an interest.

FURTHER, I do authorize my aforesaid attorney to execute, acknowledge and deliver any instrument under seal or otherwise, and to do all things necessary to carry out the intent hereof, hereby granting unto my said attorney full power and authority to act in and concerning the premises as fully and effectually as I may do if personally present.

PROVIDED, however, that all business transacted hereunder for me or for my account shall be transacted in my name, and that all endorsements and instruments executed by my said attorney for the purpose of carrying out the foregoing powers shall contain my name, followed by that of my said attorney and the designation “attorney-in-fact”.

This Power of Attorney shall not be affected by any subsequent disability or incompetence.

I further declare that any act or thing lawfully done hereunder by my said attorney shall be binding on myself and my heirs, legal and personal representatives and assigns, whether the same shall have been done either before or after my death, or other revocation of this instrument, unless and until reliable intelligence or notice thereof shall have been received by my said attorney.

IN WITNESS WHEREOF, I have hereunto set my hand and seal this the ____ day of ___________, 20___ .






Name and Address




Name and Address

STATE OF _________________

COUNTY OF ________________

PERSONALLY came and appeared before me, the undersigned authority in and for the jurisdiction aforesaid, the within named _________________, who acknowledged to me that he signed, executed and delivered the foregoing Power of Attorney on the day and year therein mentioned.

GIVEN under my hand and official seal of office, this the ____ day of

____________, 20___.



My Commission Expires:


State Specific Power of Attorney Forms

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