Fill and Sign the Power Attorney Form 481378243

SPECIAL POWER OF ATTORNEY (BANKING) PREAMBLE: This is a MILITARY POWER OF ATTORNEY prepared pursuant to Title 10, United States Code, § 1044b , and executed by a person authorized to receive legal assistance from the military services. Federal law exempts this power of atto rney from any requirement of form, substance, formality, or recording that is prescribed for powers of attorney by the laws of a state, the Distri ct of Columbia, or a territory, commonwealth, or possession of the United States. Federal law specifies that this power of attorney shall be given the same legal effect as a power of attorney prepared and executed in accordance with the laws of the jurisdiction where it is presented. K N O W A LL PERSO NS: That I, , c urren tly r e sid ing at by th is do cu m ent do m ake and appo in t , w ho se addre ss is as my true and lawful attorney-in-fact to act as follows, GRANTING unto my said Attorney full power to: Transact business for me and in my name in connection with the following bank account (s): Financial Institution: ____________________________ Checking Account Number: _____________________________ Savings Account Number: _____________________________ Loan Number: ________________________________ Safe Deposit Box: _____________________________ and for this purpose to draw, cash, discount, or otherwise deal with bills of exchange, checks, promissory notes, or other s ecurities for payment of money; to receive, endorse and collect any and all checks payable to the order of the undersigned; to execute, in my name and o n my behalf, all bonds, indemnities, applications, or other documents, which may be required by law or regulation to secure the issuance of s ubstitutes for such checks, and to give full discharge for same; to deposit in the foregoing accounts of mine any and all monies which the Grantee shall rec eive, including all bills of exchange, drafts, checks, promissory notes, and other securities for money payable or belonging to me, and for that purpose, to sign on my behalf and endorse the same for deposit and collection, and from time to time withdraw any and all monies in the foregoing a ccounts, and for that purpose, draw checks in my name; and to have access for all purposes to any and all safety deposit boxes or vaults rented in my name or in the names of any person or persons and myself, with full power to use the same for safekeeping any property or papers, and to remove therefrom at any t ime, or from time to time, any and all or part of the contents of any such box or vault and to have the power to close and surrender such box or vau lt. TERMINATION: This power shall remain in full force and effect until _____________________, unless sooner revoked or terminated by me. Notwithstanding my insertion of a specific expiration date herein, if on the above specified expiration date I shall be, or have been, carried in a military status of “missing”, “missing-in-action” or “prisoner of war,” then this power of attorney shall automatically re main valid and in full effect until sixty (60) days after I have returned to the United States Military control following termination of such status . This power of attorney shall not be affected by the disability of the principal. IN WITNESS WHEREOF , I have hereunto set my hand and seal on this day, ____________________. _____________________________________Grantor’s Signature WITNESSED: PRINT NAME: PRINT NAME: PRINT ADDRESS PRINT ADDRESS: _________________________________________________________________________________________________________________________ ACKNOWLEDGEMENT BY NOTARY PUBLIC _________________________________________________________________________________________________________________________ STATE OF ________________________, COUNTY OF _______________________, ss. The foregoing instrument was acknowledged before me by _________________________and the above named two witnesses, this ____ da y of ____________________, _______. ________________________________ Print Nam e: Notary Public _________________________________________________________________________________________________________________________ ACKNOWLEDGEMENT BY A PERSON AUTHORIZED TO ACT AS A NOTARY PURSUANT TO TITLE 10 U.S.C. 1044a _________________________________________________________________________________________________________________________ With the United States Armed Forces At ____________________________, the forgoing instrument was acknowledged before me by ______________________________ and the a bove named two witnesses, this ____day of ________________, _______. I do further certify that I am a person in the service of the U.S. Armed Forces authorized the general powers of a notary public under Title 10 U.S.C. 1044a and JAGMAN Chapter IX. __________________________________ __________________________________Print Name, Grade, Armed Force NO SEAL REQUIRED