I, __________, residing at __________ by these presents, hereby constitute make and appoint __________, residing at __________, as and for our lawful Attorney-in-Fact, to act in our name, place and stead, conferring upon him all of the following enumerated powers and every legal power which might exercise on our own behalf for or in furtherance of the following purposes:
To sign and deliver every document and to do every act necessary or proper for the execution of the mortgage to __________ on the said property known as __________, also known as Lot __________, on the __________ Tax Map, County of __________, State of __________, in the amount of $__________.
This instrument shall be construed and interpreted as a limited power of attorney.
The rights, powers, and authority of said Attorney-in Fact granted in this instrument shall commence and be in full force and effect immediately and such rights, powers, and authority shall remain in full force and effect thereafter until we give notice in writing that such power is terminated.
This Power of Attorney is effective now, and shall remain effective in the event that we become disabled, mentally incompetent, or otherwise incapacitated.
Date: __________
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STATE OF __________
COUNTY OF __________ SS:
Before me there appeared on __________, __________, to me known to be the person(s) described in and who executed the foregoing instrument, and they thereupon acknowledged that they executed and delivered the same as their act and deed for the purposes expressed therein.
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Notary Public
Record and Return to:
__________
Title Number: __________
Prepared by: __________