Pennsylvania General Power Of Attorney Form Page 7

Acknowledgment by Agent

I, ___________________________________, have read the attached power of attorney

and am the person identified as the Agent for the Principal. I hereby acknowledge that in

the absence of a specific provision to the contrary in the power of attorney or in 20

Pa.C.S. when I act as agent:

I shall exercise the powers for the benefit of the principal.

I shall keep the assets of the principal separate from my assets.

I shall exercise reasonable caution and prudence.

I shall keep a full and accurate record of all actions, receipts and disbursements on behalf

of the principal.

______________________________

Signature of Agent

_______________________________

Date

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