Fms Form 234 - General Power Of Attorney
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General Power of Attorney
BY A CORPORATION FOR THE COLLECTION OF CERTAIN
U
S
T
CHECKS DRAWN ON THE
NITED
TATES
REASURY
Know all by these presents:
That _____________________________________________________________________ , a corporation
(Exact name of corporation)
duly organized and existing under and by virtue of the laws of _____________________________________
with its principal office at ________________________________________________ , does hereby appoint
____________________________ , whose address is _________________________________________ as
attorney to receive, endorse, and collect checks in its name, drawn on the United States Treasury, and to give
full discharge for same.
The said corporation hereby ratifies and confirms all that may lawfully be done by virtue hereof.
IN WITNESS WHEREOF said corporation has caused this instrument to be executed in its behalf,
pursuant to authority of its Board of Directors, by its_____________________________________ and its
(Official title of officer)
corporate seal to be hereunto attached, attested by its secretary or assistant secretary, this
_____ day of__________________ , 20___
_______________________________
(Name of corporation)
[IMPRESS SEAL HERE]
By _______________________________
(Official signature of officer)
Attest: _____________________________
_______________________________
Secretary
(Official title of officer)
* Personally appeared before me the above-named ________________________________________________
known or proved to me to be the same person who executed the foregoing instrument, and to be the
___________________ of ______________________________________________________________ and
(Title of officer)
(Name of Corporation)
acknowledged to me that he executed the same as his free act and deed and the free act and deed of said
corporation.
WITNESS my signature, official designation, and seal.
________________________________
[IMPRESS SEAL HERE]
(Signature of attesting officer)
________________________________
(Official designation)
Dated at ____________________ , this ______ day of ____________________ , 20 _____
My commission expires ______________________, 20 _____
IMPORTANT – Do not execute this instrument without first reading the instructions on the next
page. Exact compliance with these instructions will avoid complications.
* See Instructions on next page – Paragraphs 2(a) and 2(b)
DEPARTMENT OF THE TREASURY
FORM
FMS
234
(SUPERSEDES SF 234 (APRIL 1963)
FINANCIAL MANAGEMENT SERVICE
1-04
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