Power of Attorney Demand

POWER OF ATTORNEY DEMAND

This Power of Attorney Demand is made effective as of by and between Principal Name: whose principal address is (hereinafter "Principal"), and Attorney-in-Fact Name: whose address is (hereinafter "Agent").

RECITALS

WHEREAS, Principal is the holder of certain claims, accounts, obligations, or rights to payment, records, or property described further herein and desires that those matters be asserted, demanded, collected, settled, or otherwise enforced; and

WHEREAS, Principal wishes to appoint Agent to act as Principal's lawful attorney-in-fact with full authority to make demands, give notices, execute instruments, initiate collection or enforcement actions, and receive and endorse funds, subject to the terms and limitations of this instrument; and

WHEREAS, Principal desires that third parties and obliged persons rely upon and honor the demands and instruments executed by Agent in accordance with the authority granted herein.

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, and intending to be legally bound, the parties agree as follows:

1. GRANT OF AUTHORITY

Principal hereby appoints Agent as Principal's true and lawful attorney-in-fact with full power and authority to act on Principal's behalf to demand, collect, compromise, settle, and receive payment of any and all debts, claims, judgments, or other amounts due to Principal; to endorse checks and other instruments; to obtain and inspect records, accounts, invoices, correspondence, contracts, and other documentary evidence; to give written or oral notices of demand; to sign, execute and deliver releases, waivers, satisfactions, and other instruments necessary or convenient to effectuate a demand or collection; and to initiate, prosecute, defend, or settle administrative proceedings or civil litigation related to such demands, in each case as Agent, in Agent's discretion, deems necessary to vindicate or protect Principal's rights.

2. SPECIFIC DEMAND

The subject matter of this demand consists of the following (provide a concise description of the claim, account, contract, invoice, or obligation to be demanded):

3. DURATION, EFFECTIVENESS AND DURABILITY

This Power of Attorney shall become effective on the Effective Date set forth above and shall remain in full force and effect until revoked in writing by Principal, as provided in Section 7 below, or until the Expiration Date set forth below, if any. The Principal indicates the durable nature of this appointment by selecting the durability option below:

Durable power of attorney; this appointment shall not terminate upon Principal's subsequent incapacity or disability.

4. LIMITATIONS; PROHIBITED ACTIONS

Agent shall not: (a) make gifts or gratuitous transfers of Principal's property; (b) create or modify a will or testamentary disposition on Principal's behalf; (c) change beneficiary designations on insurance or retirement accounts; or (d) exercise any power that would require judicial appointment of a conservator or guardian. Any action by Agent outside the scope of authority expressly granted herein shall be voidable by Principal.

5. THIRD-PARTY RELIANCE

Third parties, including banks, other financial institutions, obligors, and governmental or administrative entities, may rely upon a copy or facsimile of this instrument and the statements and actions of Agent, and are entitled to rely upon documents executed by Agent within the scope of authority granted herein without further inquiry. Principal hereby authorizes such third parties to accept and act upon any demand, receipt, release, or other instrument executed by Agent.

6. INDEMNIFICATION

Principal agrees to indemnify and hold harmless Agent from and against any claims, losses, costs, liabilities, or expenses (including reasonable attorneys' fees) arising from Agent's good faith performance of the powers conferred herein, except for liability resulting from Agent's gross negligence, willful misconduct, or fraud.

7. REVOCATION

This Power of Attorney may be revoked by Principal at any time by delivering written notice of revocation to Agent and to any third party to whom Agent has presented this instrument. Revocation shall be effective upon actual receipt by Agent or by a third party relying on written notification of revocation.

8. NOTICES

Notices shall be effective upon receipt when personally delivered, sent by certified mail, or sent by nationally recognized overnight courier to the addresses set forth above, or to such other address as a party may designate by notice in accordance with this Section.

9. AMENDMENTS; WAIVER

This instrument may be amended only by a written instrument signed by Principal and Agent. No waiver of any provision shall be effective unless in writing and signed by the waiving party. A waiver of any breach shall not constitute a waiver of any subsequent breach.

10. GOVERNING LAW

This Power of Attorney shall be governed by and construed in accordance with the laws of the State of without regard to its principles of conflicts of law.

11. ENTIRE AGREEMENT; SEVERABILITY

This instrument constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral. If any provision of this instrument is held invalid or unenforceable, such provision shall be severed and the remainder of this instrument shall remain in full force and effect.

12. COUNTERPARTS; ELECTRONIC SIGNATURES

This Power of Attorney may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument. Facsimile, electronic image, or other reproduced signatures shall be treated as original signatures for all purposes.

13. AGENT ACCEPTANCE

By signing below, Agent accepts the appointment and agrees to exercise the powers conferred herein in a fiduciary capacity for the benefit of Principal and in accordance with the terms of this instrument.

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