Notary Power of Attorney Form

Please fill out the form with your information below.

I. Principal Information

Attorney-in-Fact Information

II. Grant of Authority

I, the undersigned Principal, hereby appoint the above-named Attorney-in-Fact to act in my name, place, and stead to execute the following powers:

• Manage financial transactions.

• Conduct real estate transactions.

• Make healthcare decisions.

• File taxes and handle government documents.

This Power of Attorney is effective:

• Immediately upon signing.

• On the following date:

III. Notary Section

State of
County of

On this day of , 20, before me, the undersigned Notary Public, personally appeared (Principal), known to me or satisfactorily proven to be the person whose name is subscribed to the foregoing instrument and acknowledged that they executed the same for the purposes therein contained.

Principal

Date:

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