|
General Power of Attorney
Document
We,
_________________, hereby appoint ________________, our Forwarding Agent,
to act in our capacity to do every act that we may legally do
through an attorney in fact to handle all business including our health
and welfare.
This power shall be in full force and effect on the date below
written and shall remain in
full force and effect thereafter.
Dated:
_______________, _________.
Individual______________________________
Individual______________________________
STATE OF
KENTUCKY
COUNTY OF
JEFFERSON
Before me,
the undersigned authority, on this _____ day of __________________,
_______,
personally appeared _____________________, to me well known to be the
person described in and who signed the Foregoing, and acknowledged to me
that
they
executed the same freely and voluntarily for the uses and purposes therein
expressed.
WITNESS my
hand and official seal the date aforesaid.
________________________
NOTARY
PUBLIC
My
Commission Expires: ____
|
