Special Power Of Attorney For Closing Real Estate Transaction Form Page 4

STATE OF PENNSYLVANIA

COUNTY OF ______________

On this, the ____________ day of __________________, ____________, before

me ________________________________________, the undersigned officer, personally

appeared _____________________________________, known to me (or satisfactorily

proven) to be the person whose name ______________________ subscribed to the

within instrument, and acknowledged that

______________________________________ (he/she/they) executed the same for the

purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

______________________________

Notary Public

Printed Name: _________________

My Commission Expires:

_____________________

Principal Name and Address

Attorney-in-Fact Name and Address

Name:

Address:

City:

State:

Zip:

State:

Zip:

Phone:

0 votes

Parent category: Legal