Before completing this power of attorney, you must follow the instructions on the JSVRO website. This document is not valid unless you go through the JSVRO process first.
SPECIALPOWEROFATTORNEY
(ROTATING)
PREAMBLE: This is a MILITARY POWER OF ATTORNEY prepared pursuant to Title 10 United States Code, Section 1044b, and executed by a person authorized to receive legal assistance from the military services. Federal law exempts this power of attorney from any requirement of form, substance, formality, or recording that is prescribed for powers of attorney by the laws of a state, the District of Columbia, or a territory, commonwealth, or possession of the United States. Federal law specifies that this 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. All adjutants and assistant adjutants; commanding, executive, and administrative officers; legal officers; officers in the grade of O-4 and above; and Marine Corps E-4 and above while holding a legal assistance billet are authorized to act as federal notaries under title 10 of the United States Code section 1044a.
Revised 7/2016
This power of attorney is set forth on
day of
2017, between the Principal,
Revised 7/2016
andthefollowingnamedAgent, who is on activedutywiththeUnitedStatesArmedForces(orisacivilianemployeeoftheUnitedStatesentitledtospecialstatusundertheU.S./Japan Statusof ForcesAgreement).ThePrincipal appoints thebelowidentifiedagent:
Agent Rank/Name:
ServiceComponent:
ThePrincipal hereby appoints theAgenttoact as attorney-in-fact todoeachandeveryact whichhe/shecouldpersonally doto: (1)Grant,sell, bargain, andconveyallright,titleandinterest in andtothefollowingmotorvehicle:
YEAR:
MAKE:
LICENSEPLATENUMBER:
SERIAL NUMBER:(2) De-registertheabovevehicle withtheappropriate UnitedStates andJapaneseauthorities.
(3) Operateanddrivetheabovevehiclefor aperiod not toexceedone hundred twenty(120)daysfrom thedateshown above. It isunderstood thatthevehicleis nottostandorbeoperatedduringanyperiodinwhichtherequiredGovernmentofJapaninspectionhasexpiredorinwhichtheJapaneseor Americaninsurancehas lapsed.
(4)Thepowertofileany and allclaims against theUnitedStates government concerningthesaidnamedvehicle.
ThePrincipalgivestheAgentallthepowerofsubstitution. The AgentcannotgiveathirdpersonaPower ofAttorneyovertheabovevehicle. Itis furtherunderstoodbythebelow-signed partiesthat thisistheonlyPower ofAttorney overamotorvehiclebeingleftonOkinawa thattheAgentis authorizedtoholduntiltheabovevehicleis properly disposed of.
IftheAgent doesnotdisposeofthevehiclewhilethisPowerofAttorney isvalid,Principal hereby makes,constitutes,andappointsthe MarineCorpsBaseProvostMarshal’sOfficeasthetrueandlawfulattorney-in-facttoderegisterthevehiclewiththeproper authorities andto abandonand surrenderitto theUnitedStates Governmentforsalvage.
THEDEREGISTRATION FEEWILLBECHARGEDTOTHEPRINCIPALIFNONEISCHOSENTHEPRINCIPALSHALLBECHARGEDTHE DEREGISTRATIONFEE.
BeitknownthatthePrincipaldoesherebyexpresslywaivewhateverrightshe/shemayhaveundertheprovisionsofDOD4160.21-M,orany regulationsor statutespertaining tothedispositionofunclaimedproperty. Beiffurther known thatthePrincipalsurrenders,declines,andotherwise renounces any andallrights andinterest in any proceedsresultingfromthesalvageofthemotorvehicle.
Revised 7/2016
TERMINATION: UnlesssoonerrevokedorterminatedbythePrincipal,thisPowerofAttorneyshallbecomeNULLandVOIDonthe soonest of: (i) one hundred twenty (120) days fromthe date shownabove: (ii) the expirationdate for eitherGovernmentof Japaninspectionof Japanese insurancecoverage;or (iii) theexpirationdateforAmericaninsurancecoverage.
By signing below, Principal states that he/she understands theterms ofthis powerof attorney and hereby givesit legal effect. We,thePrincipal andAgent,respectively, hereby acknowledgethat we have readand understandtheterms ofthis document.
(DONOT SIGN UNTIL IN FRONT OF A NOTARY)
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PRINCIPAL: (print)
AGENT:
(print)
Revised 7/2016
WITHTHEUNITEDSTATESARMEDFORCES,OKINAWA,JAPAN,SS.:
1) Onthis day of _,2016,beforetheundersigned notary,personally appeared
_,satisfactorily provento be(a)servinginor retiredfromtheArmed Forces of theUnited States, or (b)alawfuldependent ofapersonservinginor retiredfromtheArmedForces of theUnitedStates,or (c) apersonservingwith, employedby, or accompanyingtheArmedForcesoftheUnitedStates outsidethe UnitedStates andoutsidethe CanalZone, PuertoRico,Guam, andtheVirginIslands, andto betheperson whosenameis subscribedtothe withininstrument and acknowledgedthathe/she executedthesame, andtheundersigned does furthercertify that he/sheis at the dateofthis certificateanon-commissioned/commissioned officerof theArmedForces
oftheUnitedStates havingthegeneral powersofa notary public undertheprovisions of Section936or1044aofTitle10 oftheUnitedStates Code
(PublicLaw90-632and101-510).
ALL ADJUTANTS AND ASSISTANT ADJUTANTS; COMMANDING,______
EXECUTIVE, AND ADMINISTRATIVE OFFICERS; LEGAL OFFICERS; Signature of Notary
OFFICERS IN THE GRADE OFO-4 AND ABOVE; AND MARINE
CORPS E-4 AND ABOVE WHILE HOLDING A LEGAL ASSISTANCEName of Notary and Position:
BILLET ARE AUTHORIZED TO ACT AS FEDERAL NOTARIES UNDERGrade and Branch of Service:
TITLE 10 OF THE UNITED STATES CODE SECTION 1044A.NO SEALCommand or Organization:
REQUIRED BY LAW.
2) Onthis day of _, 2016,beforetheundersignednotary,personally appeared
_,satisfactorily provento be(a)servinginor retiredfromtheArmed Forces of theUnited States, or (b)alawfuldependent ofapersonservinginor retiredfromtheArmedForces of theUnitedStates,or (c) apersonservingwith, employedby, or accompanyingtheArmedForcesoftheUnitedStates outsidethe UnitedStates andoutsidethe CanalZone, PuertoRico,Guam, andtheVirgin Islands, andto betheperson whosenameis subscribedtothe withininstrument and acknowledgedthathe/sheexecutedthesame, andtheundersigned does furthercertify that he/sheis at the dateofthis certificateanon-commissioned/commissioned officerof theArmedForces
oftheUnitedStates havingthegeneral powersofa notary public undertheprovisions of Section936or1044aofTitle10 oftheUnitedStates Code
(PublicLaw90-632and101-510).
ALL ADJUTANTS AND ASSISTANT ADJUTANTS; COMMANDING,______
EXECUTIVE, AND ADMINISTRATIVE OFFICERS; LEGAL OFFICERS; Signature of Notary
OFFICERS IN THE GRADE OFO-4 AND ABOVE; AND MARINE
CORPS E-4 AND ABOVE WHILE HOLDING A LEGAL ASSISTANCEName of Notary and Position:
BILLET ARE AUTHORIZED TO ACT AS FEDERAL NOTARIES UNDERGrade and Branch of Service:
TITLE 10 OF THE UNITED STATES CODE SECTION 1044A.NO SEALCommand or Organization:
REQUIRED BY LAW.
Revised 7/2016