DIY Legal Forms

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Acknowledgment by Attorney-in-Fact

STATE OF ----------)

) s.s.:

COUNTY OF ---------)

On this [date] before me came [name], to me known and known to me to be the individual who executed the foregoing instrument and who is described in and appointed attorney-in-fact by a power of attorney executed by [name] and dated [date], and she acknowledged that she executed the foregoing instrument as the act of [name] and as his attorney-in-fact.

[signature]

Notary Public

Witness my hand and official seal.

Signature ________________________
Notary

My commission expires: _____

(Seal)