Form 5-5520 - Power Of Attorney printable pdf download

Form 5-5520

OMB No. 1076-0157

UNITED STATES

Expires: 01/31/2020

DEPARTMENT OF THE INTERIOR

BUREAU OF INDIAN AFFAIRS

POWER OF ATTORNEY

Pledging United States Bonds or Notes as Security for Grazing Permits

KNOW ALL MEN BY THESE PRESENTS that _________, ___________________________________,

(I or we)

(Permittee)

of _______________________________________________, State of ______________, partners doing

(Mailing Address)

business under the firm name of _______________________________________ a corporation

organized and existing under the laws of the State of _________________, having an office and principal

place of business at _________________________________________________________ , State of in

(Mailing Address)

pursuance of a resolution of the Board of Directors of said corporation, passed on the ______ day of

_____________ a duly certified copy of which resolution is attached hereto (strike out italicized reference

to partners and corporation if not applicable), hereby appoint the Agency Superintendent, Bureau Of

Indian Affairs and his successors in office, as attorney-in-fact to collect or to sell, assign, and transfer

certain negotiable United States bonds, or other negotiable United States obligations described as

follows:

TITLE AND SERIES

SERIAL NUMBER

AMOUNT

_________________________

_________________________,

such obligations having been deposited pursuant to authority conferred by Section 1126 of the Revenue

Act of 1925, as amended, and subject to the provisions thereof and of Treasury Department Circular No.

154, dated February 6, 1935, as security for the faithful performance of any and all conditions or

stipulations of a grazing permit accepted by the undersigned on Range Unit _____________ of the

_______________________________ Indian Reservation for a period beginning ___/___/______ and

terminating not later than ___/___/______ , attached and made a part hereof.

The undersigned agrees that in case of any default in the performance of any of the conditions or

stipulations of the grazing permit, the said attorney-in-fact shall have full power to collect said bonds and

obligations or any part thereof, or to sell, assign, and transfer said securities or any part thereof, without

notice, at public or private sale, free from any equity of redemption and without appraisement or valuation,

notice and right to redeem being waived, and to apply the proceeds of such sale or collections, in whole

or in part, to the satisfaction of any damages, demands, or deficiencies arising by reason of such default

as said attorney-in-fact may deem best. And ________ hereby for ___________ heirs, executors,

(I or we)

(my or our)

administrators, successors and assigns, ratify and confirm whatever said attorney-in-fact shall do by

virtue of these presents.

Form 5-5520 – Power of Attorney, Page 1 of 2

Permittee Initial _______

Form 5-5520 - Power Of Attorney

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