General Durable Power Of Attorney Form (Page 7 of 7) in pdf

General Durable Power Of Attorney Form Page 7

_______________________________________ [Address of Witness #2, Line 1]

_______________________________________ [Address of Witness #2, Line 2]

CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC

STATE OF ______________________

COUNTY OF ________________

This document was acknowledged before me by the principal

_____________________________[name of principal]; the agent,

__________________________ [name of agent]; witness #1

___________________________[name of witness #1]; and by witness #2

__________________________ [name of witness#2] on _____________________

[date].

[Notary Seal, if any]:

_______________________________

(Signature of Notarial Officer)

Notary Public for the State of Maryland

My commission expires:

___________________

ACKNOWLEDGMENT OF AGENT

BY ACCEPTING OR ACTING UNDER THE APPOINTMENT, THE AGENT

ASSUMES THE FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN

AGENT.

________________________________________________

[Typed or Printed Name of Agent]

________________________________________________

[Signature of Agent]

_________/_________

Agent / Grantor

General Durable Power Of Attorney Form Page 7