Durable Power Of Attorney Page 3
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3This Power of Attorney shall not be affected by subsequent disability or incapacity of the
principal, and shall continue in force even though I may suffer mental incapacity, pursuant to the
Uniform Durable Powers of Attorney Act, W. Va. Code §§ 39-4-1 thru 39-4-7.
SIGNATURE OF PRINCIPAL
Taken, sworn to and subscribed before me this
day of
,
. My commission expires
,
.
NOTARY PUBLIC
Rev. 04/2000
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