RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO
_______________________
_______________________
_______________________

Power of Attorney for Finances (Limited Power)

I, _______________ [your name], of _______________ [your city and state], appoint _______________________ [name of your attorney-in-fact] to act in my place for the purposes of:
_____________________________________________________
This power of attorney takes effect on ________________, and shall continue until terminated in writing, or until ________, whichever comes first.
I grant my attorney-in-fact full authority to act in any manner both proper and necessary to the exercise of the foregoing powers, and I ratify every act that my attorney-in-fact may lawfully perform in exercising those powers.
I agree that any third party who receives a copy of this document may act under it. Revocation of the power of attorney is not effective as to a third party until the third party has actual knowledge of the revocation. I agree to indemnify the third party for any claims that arise against the third party because of reliance on this power of attorney.
Signed: This ________ day of ___________, ____.
State of: _________________ County of: ________________________

Signature: ______________________________________, Principal
Social Security Number: ___________
Witnesses
On the date written above, the principal declared to me that this instrument is his or her financial power of attorney, and that he or she willingly executed it as a free and voluntary act. The principal signed this instrument in my presence.
Witness 1
Signature: _____________________________________
Name: ___________________________________
Address:	________________________
________________________
Witness 2
Signature: ___________________________________
Name: ___________________________________
Address:	________________________
________________________

Certificate of Acknowledgment of Notary Public

State of _______________________________	)
	)	ss
County of _____________________________	)

On _____________,.______, before me, ___________, a notary public in and for said state, personally appeared _____________, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument, and acknowledged to me that he or she executed the same in his or her authorized capacity and that by his or her signature on the instrument, the person, or the entity upon behalf of which the person acted, executed the instrument.

	WITNESS my hand and official seal.
	_____________________________________
	Notary Public for the State of ______________
	My commission expires __________________
[NOTARY SEAL]

Acknowledgement of Attorney-in-Fact

By accepting or acting under the appointment, the attorney-in-fact assumes the fiduciary and other legal responsibilities and liabilities of an agent.

Name of Attorney-in-Fact: _____________________________________

Signature of Attorney-in-Fact: ____________________________________

Preparation Statement
This document was prepared by:
Name: ____________________
Address:	________________________
________________________