MILITARY POWER OF ATTORNEY
“THIS IS A MILITARY POWER OF ATTORNEY PREPARED AND EXECUTED PURSUANT TO TITLE 10, UNITED STATES CODE, SECTION 1044b BY A PERSON AUTHORIZED TO RECEIVE LEGAL ASSISTANCE FROM THE MILITARY SERVICES, FEDERAL LAW EXEMPTS A MILITARY POWER OF ATTORNEY FROM ANY REQUIREMENT OF FORM, SUBSTANCE, FORMALITY OR RECORDING THAT IS PRESCRIBED FOR POWERS OF ATTORNEY BY THE LAWS OF ANY STATE, COMMONWEALTH, TERRITORY, DISTRICT, OR POSSESSION OF THE UNITED STATES. FEDERAL LAW SPECIFIES THAT A MILITARY POWER OF ATTORNEY SHALL BE GIVEN THE SAME LEGAL EFFECT AS A POWER OF ATTORNEY PREPARED AND EXECUTED IN ACCORDANCE WITH THE LAWS OF THE JURISDICTION WHERE IT IS PRESENTED.”
GRANTOR’S NAME, GRADE: ______
RESIDING AT: ______
NAMES AND AGES OF CHILDREN (if applicable): ______
KNOWN ALL MEN BY THESE, PRESENT, that I, a legal resident of (city)
______, (State) ______, desiring to execute a Power of
Attorney, do hereby make, constitute and appoint ______
Whose address is ______
My true and lawful attorney-in-fact, to act as follows, granting unto my said attorney-in-fact full power:
(1)to use, operate, insure, license and register with any state of government agency, any and all vehicles of which I am presently the registered or legal owner;
(2)to receive, endorse, cash or deposit any and all checks, vouchers, drafts, or orders for payment made payable to the undersigned, including but not limited to checks issued by the United States or any sovereign state or authority or instrumentality thereof or any officer thereof;
(3)to take possession and order the removal and shipment of any of my personal property wheresoever located;
(4)to have custody, care and control over my child/children, and to authorize and order all necessary items or services for my child’s/children’s welfare and benefit, including, but not limited to, medical, dental and surgical care, schooling, clothing, housing, food and other necessities of life and to otherwise act as temporary guardian;
(5)to obtain medical care from a duly licensed physician, and obtain medical care and treatment, including major surgery, deemed necessary by a duly licensed physician selected by my attorney-in-fact, at any hospital for the health and well-being of my child/children, and to execute any consent and release of waiver of liability required by the hospital authorities incident to medical care and treatment for my child/children;
(6)to perform any and all acts and to sign, execute and endorse any instrument necessary for the issuance or reissuing of Dependent Identification cards for any of my legal dependents as defined by applicable Army or D.O.D. regulation, instruction or directive;
(7)to perform any and all acts and sign, execute and endorse any instrument necessary to arrange for travel, at government expense or otherwise, for my legal departments as defined under applicable Army or D.O.D regulation, instruction, or directive;
(8)to prepare, sign, execute and file, in my behalf and my name, federal, state and/or local income and other tax returns as may be required;
(9)to effect the assignment or termination of U.S Government or other quarters, to sign for quarters, arrange for final inspection and clear quarters, and accept responsibility for the property therein; and to sign in my name, place and stead any document whatsoever necessary under the law to accomplish the above listed powers, and to make, sign, endorse, act, receive or accept any instrument of any kind or nature as may be necessary or proper to accomplish any of the above said powers.
THIS POWER OF ATTORNEY SHALL NOT BE AFFECTED BY DISABILITY OF THE PRINCIPAL AND SHALL CONTINUE TO BE EFFECTIVE SHOULD I BECOME DISABLED, INCOMPETENT OR INCAPACITATED PRIOR TO THE BELOW-STATED EXPIRATION DATE.
I hereby declare that if I shall be reported or listed as ‘missing’ or “missing in action” or as a “prisoner of war” as those phrases are used in military parlance, such designated shall not bar my attorney-in-fact from fully and completely exercising and continuing to exercise any and all powers granted hereunder, and that such report or listing shall neither constitute nor be interpreted as constituting notice of my death nor shall it operate to revoke this instrument.
And I hereby declare that unless sooner terminated by me, and expect as provided below, all powers granted herein to my attorney-in-fact shall terminate and this Power of Attorney shall become null and void after the _____day of ______, 2004.
Notwithstanding my insertion of a specific expiration date herein, if on the above specified expiration date I shall be, or have been, carried in a military status of “missing”, “missing in action”, or “prisoner of war”, then this power of attorney shall automatically remain valid and in full effect until (60) days after I have returned to United States military control following termination of such status.
IN WITNESS WHEREOF, I have hereunto set my hand and seal at ______, this _____ day of ______, 2004
______
Grantor’s Signature
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On the above date______
known to me to be the individual described in and who executed the foregoing instrument
duly appeared before me and acknowledged to me that the same as his/her own free act
and deed.
(SEAL) ______
NOTARY PUBLIC
My Commission expires on ______
Adjutant Authority to act as Notary Public under provisions of section 936 of Title 10