Durable General Power Of Attorney Form Page 7
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7THUS DONE AND SIGNED in _________________________ Parish, Louisiana, on
_____________________________, 20___.
WITNESS:
______________________________________ _______________________________________
WITNESS
PRINCIPAL
______________________________________ ________________________________________
WITNESS
AGENT
_____________________________________________________
NOTARY PUBLIC, PARISH OF _____________________________ , STATE OF LOUISIANA
MY COMMISSION EXPIRES ON : _______________________
Page 7 of 7 ______________________________ (Principal)
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