(TYPE 2)


By affixing my signature below I, _________________, residing at _______________, __________________________ make, constitute, and appoint, _________________,

residing at _______________________________________ my true and lawful attorney

in fact, for me and in my name and stead, and to my use, for the purpose of __________ __________________________________. 


I hereby give to my attorney full authority and power to do anything and everything whatsoever required or obligated to be done, at least to the extent I could or might do, with full power of substitution and revocation.  I hereby confirm and sanction all that said attorney shall lawfully do or cause to be done, acting on my behalf and in my stead.



Signed this _________ day of ______________________________.