General Power Of Attorney Form

Topic 1: Power of Attorney

Exhibit A: General Power of Attorney

General Power of Attorney

(NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND

SWEEPING.)

State of ______________

County of ____________

I ____________________________, appoint __________________ to be my attorney-in-fact,

to act in my name in any way which I could act for myself, with respect to the following

matters:

(DIRECTIONS: Initial the line opposite any one or more of the subdivisions as to which

the principal desires to give the attorney-in-fact authority.)

______ (1)

Real property transactions

______ (2)

Personal property transactions

______ (3)

Bond, share, stock, securities and commodity transactions

______ (4)

Banking transactions

______ (5)

Safe deposits

______ (6)

Business operating transactions

______ (7)

Insurance transactions

______ (8)

Estate transactions

______ (9)

Personal relationships and affairs

______ (10)

Social security and unemployment

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Parent category: Legal