Fill and Sign the Special Power Attorney Form

SPECIAL POWER OF ATTORNEY (HOUSEHOLD GOODS) 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 attorney from any requirement of form, substance, formality, or recording that is prescribed for powers of attorney by the laws of a state, the District 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. KNOW ALL PERSONS: That I,       , currently residing at       by this document do make and appoint       , whose address is       as my true and lawful attorney-in-fact to act as follows, GRANTING unto my said Attorney full power to: Take possession and order the removal and shipment of my household goods, personal baggage, or other personal property and to cause such property to be removed from its present location at       and to cause it to be shipped on Government orders (to such place or places as my attorney-in-fact in his/her discretion may deem appropriate) (to such military quarters as are designated and assigned to me by the Housing Office at       ) (to the following residential address:       ) or to any warehouse, depot, dock, or other place of storage or safekeeping, governmental or private directed by orders of appropriate U. S. Navy or military transportation officials, and to execute and deliver all necessary forms, papers, certificates and receipts to carry out the foregoing. To take possession of, receipt for and receive any of my household goods, personal baggage, or other personal property from any government housing facility, private residence, base, post, warehouse, depot, dock, place of storage, or other place governmental or private and to cause such property to be received at       or such place or places as my attorney-in-fact in his or her discretion may deem appropriate; to settle any and all claims for damages to or loss of my personal property of whatever kind and value, and to execute and deliver all necessary forms, papers, certificates and receipts to carry out the foregoing. To also do any and all acts necessary and proper to file a claim against the United States for damages to my household goods shipped from       . Further, my Attorney-in-Fact shall be empowered to receive, endorse and collect the proceeds of checks payable to my order drawn on the Treasurer of the United States for compensation received for said damaged household goods. 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 remain 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 WHEREO F, I have hereunto set my hand and seal on this day, month and year,       . _______________________________________________________ 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 ____ day of ____________________, _______. ________________________________ Print Name: 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 above 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