Fms Form 233 - Special Power Of Attorney By Individual For The Collection Of Checks Drawn On The United States Treasury Page 2
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1
2INSTRUCTIONS FOR FMS FORM 233 – READ CAREFULLY
See 31 CFR Part 240 for more information
1.
A power of attorney using this form may be executed as authority for the endorsement and collection of checks
drawn on the United States Treasury for purposes other than those identified at 31 CFR 240.16(b). This power
of attorney must name the attorney-in-fact and must recite that it is not given to carry into effect an assignment
to the attorney-in-fact, or to any other person, of the right to receive the payments therein described.
2.
The grantor should explicitly indicate whether he/she intends:
(a). The power of attorney to automatically revoke if the grantor is determined to be incompetent;
(b). The power of attorney to remain effective despite a determination that the grantor is incompetent to the
extent authorized by 31 CFR Part 240; or
(c). The power of attorney to become effective only upon a determination that the grantor is incompetent and
to remain effective as long as authorized by 31 CFR Part 240.
If the grantor fails to clearly indicate his/her intent on the power of attorney, the power of attorney shall
automatically revoke upon a determination that the grantor is incompetent.
3(a). Where desirable or where required by foreign, state or local law this power of attorney should be acknowledged
before a notary public or other officer authorized by law to administer oaths generally. If in a foreign country,
the acknowledgment should be made before a United States diplomatic or consular representative. If such an
officer is not available, it may be acknowledged before a notary or other officer authorized to administer oaths,
but his official character and jurisdiction must be certified by a United States diplomatic or consular officer,
under the seal of his office.
3(b). Where the power of attorney is acknowledged pursuant to paragraph 4(a), the seal of the attesting officer must
always be impressed (or stamped) provided, however, that where acknowledgements before a notary public, or
other officer authorized by law to administer oaths, are not thus authenticated by the official impression seal of
such officer, the power should be accompanied by a certificate from the proper official showing that the officer
was in commission on the date of the acknowledgment. The date when the officer’s commission expires should
appear in any event. If a certificate is furnished, such certificate should show the dates of the beginning and
expiration of the officer’s commission, and such period of commission should include the date of acknowledg-
ment of the power.
3(c). Notwithstanding the foregoing, persons subject to military jurisdiction may acknowledge powers of attorney
before officers specially designated for that purpose pursuant to law.
4.
This power of attorney is revoked by the death of the grantor and may also be revoked by notice from the
grantor to the parties concerned. Notice of revocation to the Treasury will not ordinarily serve to revoke the
power.
5.
If it is desired that checks be mailed to the attorney instead of to the payee, formal notice of change in the post-
office address, identifying the checks affected, should be forwarded to the administrative office that authorized
issuance of the checks.
6.
POWERS OF ATTORNEY NEED NOT BE FILED WITH THE UNITED STATES TREASURY.
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