Missouri Durable Power Of Attorney Page 6
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6IN WITNESS WHEREOF, I have executed this power of attorney this ____ day
of __________________________, 20______.
**
SSN:
STATE OF MISSOURI
)
) ss.
COUNTY OF _____________)
On this __________________________ day of __________________________,
20____, before me personally came __________________________, to me known to be the
individual described in and who executed the foregoing power of attorney, and acknowledged
that he executed the same as his free and voluntary act and deed.
IN WITNESS WHEREOF I hereunto set my hand and official seal in said County
and State on the date first above written.
Notary Public
Commissioned in ___________ County, Missouri
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