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STATE OF GEORGIA COUNTY OF _________________________ FINANCIAL POWER OF ATTORNEY I,_______________________________, (hereinafter 'Principal'), a legal resident of _____________________________ County, Georgia, do hereby constitute and appoint ________________________________________ my true and lawful attorney-in-fact (hereinafter 'Agent') for me and give such person the power(s) specified below to act in my name, place, and stead in any way which I, myself, could do if I were personally present with respect to the following matters:
This Power of Attorney is effective immediately and shall continue in force until notice of revocation is given by me in writing to my Agent. In the event that ________________________________________, is unable or willing to serve, then I designate _______________________________, as successor or contingent agent. In the event that _____________________, is unable or unwilling to serve, then I designate __________________________________, and in the event that neither are able or willing to serve then I designate _____________________________.
It is my desire and intention that this power of attorney shall not be affected by my subsequent disability, incapacity, or mental incompetence. Any and all acts done by the Agent pursuant to the powers conveyed herein during any period of my disability or incapacity shall have the same force and effect as if I were competent and not disabled. I may, at any time, revoke this power of attorney, but it shall be deemed to be in full force and effect as to all persons, institutions, and organizations which shall act in reliance thereon prior to the receipt of written revocation thereof signed by me and prior to receipt of actual notice of my death. I do hereby ratify and confirm all acts whatsoever which my Agent shall do, or cause to be done, in or about the premises, by virtue of this power of attorney. All parties dealing in good faith with my Agent may fully rely upon the power of and authority of my Agent to act for me on my behalf and in my name, and may accept and rely on agreements and other instruments entered into or executed by the agent pursuant to this power of attorney. This instrument shall not be effective as a grant of powers to my Agent until my Agent has executed the Acceptance of Appointment appearing at the end of this instrument. This instrument shall remain effective until revocation by me or my death, whichever occurs first.
COMPENSATION OF AGENT [initial the line opposite your choice] 1. My Agent shall receive no compensation for services rendered. ________ 2. My Agent shall receive reasonable compensation for services rendered. ________ 3. My Agent shall receive $________ for services rendered. ________ IN WITNESS WHEREOF, I have herunto set my hand and seal on this ________ day of _________________, 200 ___.
______________________________ PRINCIPAL
WITNESSES: ______________________________ ______________________________ ______________________________ signature and address
______________________________ ______________________________ ______________________________ signature and address
I, __________________________________, a Notary Public, do hereby certify that __________________________ personally appeared before me this date and acknowledged the due execution of the foregoing Power of Attorney.
STATE OF GEORGIA COUNTY OF ________________________ ACCEPTANCE OF APPOINTMENT I, ______________________________, have read the foregoing Power of Attorney and am the person identified therein as Agent for ____________________________, the Principal named therein. I hereby acknowledge the following:
I hereby accept the foregoing appointment as Agent for the Principal with full knowledge of the responsibilities imposed on me, and I will faithfully carry out my duties to the best of my ability.
DATED:_______________________, 200 ___.
I, ____________________________________, a Notary Public, do hereby certify that ________________________________________ appeared before me this date and acknowledge the due execution of the foregoing Acceptance of Appointment.
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