Power Of Attorney Delegating Parent'S Power Over Minor Child Page 3

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DO NOT WRITE BELOW THIS LINE UNLESS YOU ARE IN FRONT OF
TWO WITNESSES AND A NOTARY PUBLIC
SIGNED:
______________________________________.
(9)
WITNESSES:
(9)_______________________________
(9)_______________________________
(10)
STATE OF MICHIGAN)
)ss
COUNTY OF ________)
On this ________ day of ______________________, 2000, before me, a notary public in
and for said county, personally appeared the above-named principal, who is known to me as the
person who executed the above Power of Attorney and acknowledged the same to be her/his free
act and deed.
__________________________________.
NOTARY PUBLIC
___________________ County, Michigan
My Commission Expires: _____________
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