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Illinois statutory power of at... DECLARATION FOR MENTAL HEALTH TREATMENT I , being an adult of sound mind, willfully and voluntarily make this declaration for mental health treatment to be followed if it is determined by 2 physicians

Maryland general power of atto... POWER OF ATTORNEY: CARE AND CUSTODY OF CHILD OR CHILDREN KNOW ALL MEN BY THESE PRESENTS: That the undersigned, , parent(s) of the child(ren) identified below, residing at hereby make, constitute and

Utah special or limited power... Prepared by, recording requested by and return to: Name: Company: Address: City: State: Phone: Fax: Zip: ----------------------Above this Line for Official Use Only--------------------- SPECIAL POWER

Indiana limited power of attor... Prepared by recording requested by and return to Name Company Address City State Phone Fax Zip ----------------------Above this Line for Official Use Only--------------------- SPECIAL POWER OF ATTORNEY FOR CLOSING REAL ESTATE TRANSACTION Agent for Seller STATE OF INDIANA COUNTY OF KNOW ALL MEN BY THESE PRESENT THAT I whose address is City State Zip desiring to execute a SPECIAL POWER OF ATTORNEY hereby appoint of GRANTING unto my Attorney-in-Fact full power to To do all things necessary to close on the sale of the property described below commonly known as address with full power and authority for me and in my name to execute any and all documents necessary to effect the sale conveyance and settlement on said property to any person or persons of his choosing including but not limited to deeds checks receipts releases warranties affidavits contracts addenda settlement statements loan commitments and disclosure statements truth-in-lending statements all forms of commercial papers endorsements to checks or the like and any such other instrument or instruments in writing of whatever kind character and nature Special Power of Attorney Page 1 of 4 as may be necessary to complete the sale financing arrangements and the settlement process. FURTHER GRANTING full power and authority to collect and receive any funds or proceeds of said sale in any manner which in his sole discretion he sees fit. The legal description of the property is as follows to-wit See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description I hereby ratify and confirm all that said attorney-in-fact shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted* All acts done by means of this power shall be done in my name and all instruments and documents executed by my Attorney hereunder shall contain my name followed by that of my attorney and the description Attorney-in-Fact excepting however any situation where local practice differs from the procedure set forth herein in that event local practice may be followed* This SPECIAL POWER OF ATTORNEY shall be valid and may be relied upon by any third parties until such time as any revocation is recorded in the recorder s office of the county where the land is located* DATED this the day of 20. Signature Print Name Witnessed by Before me the undersigned a Notary Public in and for said County and State this day of 20 personally appeared acknowledged the execution of the foregoing instrument. Notary Public My commission expires Principal Name and Address Attorney-in-Fact Name and Address EXHIBIT A Exhibit A. FURTHER GRANTING full power and authority to collect and receive any funds or proceeds of said sale in any manner which in his sole discretion he sees fit. The legal description of the property is as follows to-wit See Legal Description Attached as Exhibit A incorporated by reference as though set forth in full Legal Description I hereby ratify and confirm all that said attorney-in-fact shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted* All acts done by means of this power shall be done in my name and all instruments and documents executed by my Attorney hereunder shall contain my name followed by that of my attorney and the description Attorney-in-Fact excepting however any situation where local practice differs from the procedure set forth herein in that event local practice may be followed* This SPECIAL POWER OF ATTORNEY shall be valid and may be relied upon by any third parties until such time as any revocation is recorded in the recorder s office of the county where the land is located* DATED this the day of 20.

Idaho revocation of general du... REVOCATION OF POWER OF ATTORNEY I, , Declarant, having executed a General Durable Power of Attorney on the day of , 20 , naming my attorney-in-fact/agent, do hereby revoke that Power of Attorney pursuant

Health care power of attorney... GENERAL DURABLE POWER OF ATTORNEY THE POWERS YOU GRANT BELOW ARE EFFECTIVE EVEN IF YOU BECOME DISABLED OR INCOMPETENT CAUTION: THIS IS AN IMPORTANT DOCUMENT. IT GIVES THE PERSON WHOM YOU DESIGNATE

Kansas general power of attorn... POWER OF ATTORNEY: CARE AND CUSTODY OF CHILD OR CHILDREN KNOW ALL MEN BY THESE PRESENTS: That the undersigned, , parent(s) of the child(ren) identified below, residing at hereby make, constitute and

New hampshire special or limit... This Power of Attorney for Real Estate Transaction form is for a Purchaser to authorize an attorney-in-fact to execute all documents and do all things necessary to purchase a particular parcel of

Louisiana power of attorney to... State of Louisiana Parish of KNOW ALL PERSONS BY THESE PRESENTS THAT I/We whose address is appoint of Parish Louisiana as my Attorney-in-Fact to act as follows GRANTING unto my Attorney-in-Fact full power to Do all things necessary to sell or transfer the property described below including but limited to execution of a bill of sale title odometer statement request for release of liens and other documents and to receive all funds from the purchase of same. Property is One 1 Motor Vehicle Model Make Body Type Vehicle Identification Number VIN Year I hereby ratify and confirm all that said attorney-in-fact shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. All acts done by means of this power shall be done in my name and all instruments and documents executed by my Attorney hereunder shall contain my name followed by that of my attorney and the description Attorney-in-Fact excepting however any situation where local practice differs from the procedure set forth herein in that event local practice may be followed. This LIMITED POWER OF ATTORNEY shall be valid and may be relied upon by any third parties until such time as they receive notice of revocation of same. WITNESS my signature this the day of 20. Signature STATE OF LOUISIANA PARISH OF I a Notary Public hereby certify that whose name is signed to the foregoing instrument and who is known to me acknowledged before me on this day that being informed of the contents of the conveyance he/she/they executed the same voluntarily on the day the same bears date. LIMITED POWER OF ATTORNEY FOR SALE OF MOTOR VEHICLE To authorize another to sign bill of sale title and other documents. State of Louisiana Parish of KNOW ALL PERSONS BY THESE PRESENTS THAT I/We whose address is appoint of Parish Louisiana as my Attorney-in-Fact to act as follows GRANTING unto my Attorney-in-Fact full power to Do all things necessary to sell or transfer the property described below including but limited to execution of a bill of sale title odometer statement request for release of liens and other documents and to receive all funds from the purchase of same. Property is One 1 Motor Vehicle Model Make Body Type Vehicle Identification Number VIN Year I hereby ratify and confirm all that said attorney-in-fact shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted* All acts done by means of this power shall be done in my name and all instruments and documents executed by my Attorney hereunder shall contain my name followed by that of my attorney and the description Attorney-in-Fact excepting however any situation where local practice differs from the procedure set forth herein in that event local practice may be followed* This LIMITED POWER OF ATTORNEY shall be valid and may be relied upon by any third parties until such time as they receive notice of revocation of same. WITNESS my signature this the day of 20. Signature STATE OF LOUISIANA PARISH OF I a Notary Public hereby certify that whose name is signed to the foregoing instrument and who is known to me acknowledged before me on this day that being informed of the contents of the conveyance he/she/they executed the same voluntarily on the day the same bears date.

Indiana general durable power... This General Durable Power of Attorney is a general, durable power of attorney which is effective IMMEDIATELY. You can use this form to appoint an attorney-in-fact (agent) to make decisions regarding

Colorado special or limited po... Prepared by, recording requested by and return to: Name: Company: Address: City: State: Phone: Fax: Zip: ----------------------Above this Line for Official Use Only--------------------- SPECIAL POWER

Temporary medical power form R.S. 2. To authorize any and all medical and dental care for the health and well being of the medical and dental exams and tests x-rays surgeries anesthesia and hospital care. This Special Power of Attorney does not give the Attorney in Fact the power to consent to the marriage or adoption of the child or incapacitated person. earlier by the parent or guardian in writing. DELEGATION OF POWER BY PARENT OR GUARDIAN PURSUANT TO 15-14-105 C. R.S. I full name parent or guardian of the minor child ren or incapacitated person s named below Full Name of Child Incapacitated Person or Date of Birth Relationship I hereby authorize and appoint name of person as Attorney in Fact for me with full authority to act in my place as follows 1. To perform any and all acts necessary for the day-to-day care custody education recreation and property of the above-named minor child or incapacitated person consistent with the provision of 15-14-105 C. R.S. 2. To authorize any and all medical and dental care for the health and well being of the medical and dental exams and tests x-rays surgeries anesthesia and hospital care. DELEGATION OF POWER BY PARENT OR GUARDIAN PURSUANT TO 15-14-105 C. R*S* I full name parent or guardian of the minor child ren or incapacitated person s named below Full Name of Child Incapacitated Person or Date of Birth Relationship I hereby authorize and appoint name of person as Attorney in Fact for me with full authority to act in my place as follows 1. To perform any and all acts necessary for the day-to-day care custody education recreation and property of the above-named minor child or incapacitated person consistent with the provision of 15-14-105 C. R*S* 2. To authorize any and all medical and dental care for the health and well being of the medical and dental exams and tests x-rays surgeries anesthesia and hospital care. This Special Power of Attorney does not give the Attorney in Fact the power to consent to the marriage or adoption of the child or incapacitated person* earlier by the parent or guardian in writing. In any case the authority granted herein shall not be valid for more than 12 months from the date of this document. Date Parent/Guardian Signature Subscribed and affirmed or sworn to before me in the County of State of this day of 20. My Commission Expires Notary Public/Clerk JDF 751 3/08 DELEGATION OF POWER BY PARENT OR GUARDIAN PURSUANT TO 15-14-105 C. DELEGATION OF POWER BY PARENT OR GUARDIAN PURSUANT TO 15-14-105 C. R*S* I full name parent or guardian of the minor child ren or incapacitated person s named below Full Name of Child Incapacitated Person or Date of Birth Relationship I hereby authorize and appoint name of person as Attorney in Fact for me with full authority to act in my place as follows 1. To perform any and all acts necessary for the day-to-day care custody education recreation and property of the above-named minor child or incapacitated person consistent with the provision of 15-14-105 C. To perform any and all acts necessary for the day-to-day care custody education recreation and property of the above-named minor child or incapacitated person consistent with the provision of 15-14-105 C. R*S* 2. To authorize any and all medical and dental care for the health and well being of the medical and dental exams and tests x-rays surgeries anesthesia and hospital care.

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