Form E34r Sample - Power Of Attorney (Real Estate)

SPECIAL INSTRUCTIONS

You may give special instructions on the following lines:

_________________________________________________________________________________________________________

EFFECTIVE DATE AND TERMINATION

INSTRUCTIONS: Choose the effective date of this power of attorney by initialing either (A) or (B). If neither

is initialed, this power of attorney will be effective immediately. Initial (C) if you would like this power of attorney

to automatically expire upon completion of its purpose, without any action on your part.

_____________ (A) This power of attorney is effective immediately and is not affected by my subsequent

incapacity.

_____________ (B) This Power of Attorney becomes effective upon my subsequent incapacity.

_____________ (C) This Power of Attorney shall automatically expire by its own terms upon completion of the

limited purpose set forth herein.

RELIANCE ON THIS POWER OF ATTORNEY

I, with full power of revocation, ratify and confirm all that my agent shall lawfully do or cause to be done by

virtue of this Power of Attorney and the powers contained herein. Any person, including my agent, may rely upon

the validity of this power of attorney or a copy of it unless that person knows it has terminated or is invalid.

SIGNATURE AND ACKNOWLEDGMENT

__________________________________________

_____________________________________________________

Date

Signature of Principal

Print your name: ____________________________________

Address: __________________________________________

_____________________________________________________

Your telephone number: ______________________________

State of ___________________________

County of _________________________

This Power of Attorney was acknowledged before me on _____________________________________, (date) by

__________________________________________________________. (Name of Principal)

_____________________________________________________

Signature of notary

My commission expires: ______________________________

No. e34R. Rev. 11-09.

POWER OF ATTORNEY (REAL ESTATE)

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Form E34r Sample - Power Of Attorney (Real Estate) - 2009 Page 2