CO Acknowledgment-Attorney-in-Fact 1

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CO Acknowledgment-Attorney-in-Fact 1

Form Document
08/29/2005
V 1

State of _____________________

County of ___________________

The foregoing instrument was acknowledged before me this _____ (date) _____ by _____ (name of attorney-in-fact) _____ as attorney-in-fact on behalf of _____ (name of principal) _____.

________________________________________________

(signature of person taking acknowledgment)

(title or rank)

(serial number, if any)

No guidelines are available for this form at this time.