#4400
@001 State the name of the principal (person giving power):
@440 Enter the place of residence of the principal:
@441 State the name of the attorney:
@442 Enter the place of residence of the attorney:
#4401 Will the attorney have BANKING authority?
#if#4401
@443 Name the bank (do not use word bank if it is last):
@444 Enter the city and state where the bank is located:
#endif
#4402 Will the attorney execute a deed or real estate conveyance?
#if#4402
@445 State the description of the property:
#endif
#4403 Will the attorney obtain/review educational records?
#if#4403
@300 Enter the name of the school or college:
@301 Enter the city and state where the school is located:
#endif
#4404 Will the attorney have IRS authority?
#if#4404
@446/@446/@466 State the forms involved:
Form 1040
Forms 940/941
KEY IN VALUE
@447 State the taxable years involved:
#endif
#4406 Will the attorney have other authority?
#if#4406
@448 State the authority NARROWLY and PRECISELY:
#endif
#4407
@449 Enter the beginning date of the power of attorney:
@450 Enter the ending date of the power of attorney:
@003 Enter the state where signed:
@004 Enter the county where signed:
#end control section
#4400
/* 4400.arm--- Simple power of attorney- Opening */


                        POWER OF ATTORNEY


@001, the "principal," of @440, herewith appoints @441 of @442, 
as their attorney in fact, to act in the place and stead and with 
the same authority as Principal would have to do the following 
acts:
#4401
/* 4401.xxx-- bank accounts */



To conduct any and all business regarding my deposit accounts, 
loans, safe deposit box, or other banking business in regard to 
the @443 Bank, of @444. This power shall specifically include, 
but is not limited to the right to deposit, withdraw, sign checks 
or drafts, make stop payment orders, and to conduct any banking 
transactions necessary or possible in regard to my banking 
relationship with the @443 Bank.
#4402
/* 4402.arm Deeds  */



To execute a deed or other instrument of conveyance conveying my 
interest in the following real property:


@445
#4403
/* Para 4403: Education records */


To examine and to order copies of any and all of my educational 
records, including both financial and student loan and health 
related records, at the following college, school or other 
educational institution:


@300 of @301, and any branches thereof
#4404
/* Para. 4404--- IRS  */



To represent me before the Internal Revenue Service in regard to 
the following taxable years and returns:


Forms: @446
Years: @447
#4406
/* Para. 4406: General */


To act for me in the regard to the following:


@448
#4407
/* Para. 4407: End of poa */


This power of attorney shall be in effect from @449 to @450.




_____________________________________________________

@001, As Principal



STATE OF @003


COUNTY OF @004


@001 personally appeared before me and acknowledged the execution 
of this power of attorney for the purposes set forth therein.



Dated: _______________________________






__________________________________________

Notary Public