Power Of Attorney

Power of Attorney, General

I, __________________(“Declarant”), residing at __________________________, hereby appoint _____________________ (“Agent”) of_______________________, as my attorney-in-fact ("Agent") to exercise the powers and discretions described below.

If the Agent is unable or unwilling to serve for any reason, I appoint________________ (“Alternate Agent”), of _______________________________, as my alternate or successor Agent, as the case may be to serve with the same powers and discretions.

Ihereby revoke any and all general powers of attorney and special powers of attorney that previously have been signed by me. However, the preceding sentence shall not havethe effect of revoking any powers of attorney that are directly related to my health care that previously have been signed by me.

My Agent shall have full power and authorityto act on my behalf. This power and authority shall authorize my Agent to manage and conduct all of my affairs and to exercise all of my legal rights and powers, includingall rights and powers that I may acquire in the future. My Agent's powers shall include, but not be limited to, the power to:

(“Describe”)


This Power of Attorney shallbecome effective immediately, and shall not be affected by my disability or lack of mental competence, except as may be provided otherwise by an applicable state statute.This is a Durable Power of Attorney. This Power of Attorney shall continue effective until my death. This Power of Attorney may be revoked by me at any time by providingwritten notice to my Agent.

__________________ Date:
Declarant

_______________ _____________________
Witness Signature: Witness Signature
Address: Address