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Special Power of Attorney Form


Special Power of Attorney

A Special Power of Attorney is usually used to give an Agent the legal ability to handle certain specific situations for you when you are unable or unavailable to execute.








Special Power of Attorney


Date ____/____/______

I, do hereby [Legal Name]

A resident of [City][State]

Located at [Address]

[City], [State] [Zip Code]

Do Hereby Appoint [Legal Name]

A resident of [City][State]

Located at [Address]

[City], [State] [Zip Code]

As my attorney-in-fact to make the following specific decisions for me:

________________________________

________________________________

________________________________

________________________________

________________________________

This Special Power of Attorney is to start to be effective on ____/____/______, and shall remain effective until ____/____/______.

I do hereby grant my attorney-in-fact complete and full authority to act in any reasonable and necessary manner for the purpose of exercising the above mentioned powers. I also, ratify all the lawfully performed acts by my attorney-in-fact in exercising those powers.

I fully understand and agree that any third party who is given a copy of this Special Power of Attorney may act relying on it. I also, agree that revocation of this Special Power of Attorney is effective as to a third party only when they receive receipt of an actual notice by the third party. If due to reliance on the Special Power of Attorney, a third party suffers any loss, I agree to pay for any third party loss.

I sign my name to this Special Power of Attorney on:

__ Day of ____ Month ____ Year



________________________________
Signature


By accepting this appointment and acting under it, I the attorney-in-fact ("Agent") do hereby assume the legal responsibilities of an agent.


_______________________ Date_____
Signature of Attorney-in-Fact


WITNESS #1)

________________________________

WITNESS #2)

________________________________





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