Limited Power Of Attorney Form printable pdf download

Limited Power Of Attorney Form

LIMITED POWER OF ATTORNEY

Date

hereby name and appoint

(Name and Address of Purchaser)

(Name of Dealership Personnel)

(Name and Address of Dealership)

Employees of RegUSA

to act for me, in applying for an original or duplicate certificate of title, to register, transfer title, or record a lien to

the motor vehicle, mobile home or vessel described below, and to print my name and sign their name, in my

behalf. My attorney-in-fact can also file for and collect any overpayment of fees and taxes from the state office to

which said overpayment was remitted. My attorney-in-fact can also do all things necessary to the application or

any other related instrument and to bind me in as sufficient a manner as I myself could do, were I personally

present and signing the same.

With full power of substitution and revocation, I hereby ratify and confirm whatever my said attorney-in- fact may

lawfully do or cause to be done in respect of registering or titling the below-referenced vehicle.

(Vehicle Year)

(Vehicle Make)

(Vehicle Identification Number)

(Signature of Owner/Registrant/Grantor)

Sworn to (or affirmed) and subscribed before me this

day of

(SEAL)

(Signature of Notary)

THIS FORM IS INVALID WITHOUT NOTARIZATION

115 Poheganut Drive, Suite 201

Groton, CT

06340

800.876.2312

Format Rev. 01/21/14

limited dual poa_mi only (rev2014_0121).docx

1 of 1

Content Rev. 10/04/2013

Limited Power Of Attorney Form