Special Power Of Attorney Affidavit - Corporation (Page 2 of 2) in pdf

Special Power Of Attorney Affidavit - Corporation Page 2

ITY OF

ARASOTA

EVELOPMENT

PPLICATION

Special Power of Attorney Affidavit - Not Corporation

This _______ day of __________________, ________, I, ___________________________________________

________________________________________________________________

[insert

address],

the

owner/contract purchaser [circle one] of _______________________________________________________

_____________________________________________ [describe zoning lot(s) by address and tax PIN

number and attach legal description] make, constitute, and appoint ________________________________

of ________________________________________________ [insert address], my true and lawful attorney-

in-fact, and in my name, place and stead giving unto said _________________________________________

_______________________________________ full power and authority to do and perform all acts and

make all representations necessary in connection with the following Development Approval Applications

filed with the City of Sarasota:

The right, powers and authority of said attorney-in-fact herein granted shall commence and be in full force

and effect on ____________________, _______, and shall remain in full force and effect thereafter until

actual notice, be certified mail, return receipt requested is received by the Office of the City Auditor and

Clerk for the City of Sarasota stating that the terms of this power have been revoked or modified.

______________________________________

Owner/Contract Purchaser

[circle one]

Print Name: ____________________________

STATE OF FLORIDA

COUNTY OF SARASOTA

The foregoing Special Power of Attorney Affidavit was acknowledged before me this __________ day of

______________, _______, by ____________________________ who is personally known to me or has

produced ___________________________________ as identification.

_______________________________________

Notary Public

State of Florida at Large

My commission expires: ______________________

Form G

December 2006

Special Power Of Attorney Affidavit - Corporation Page 2