Durable Limited Power of Attorney
Dated: July 13, 2009 I, John Doe (“Grantee”) of 12345 Somedrive, City ST 12345 do hereby immediately grant power of attorney to perform these specific acts: in the case where I can not otherwise act for myself, to Sarah Somebody (“attorney-in-fact”) of 54321 Otherdirve, City ST 12345 to act as my attorney in accordance with the following: 1. I, in accordance with the Laws of Alabama give my attorney-in-fact the maximum power under law to perform any of the above listed acts on my behalf any action that I could otherwise do personally. 2. My attorney-in-fact accepts this appointment and agrees to act of my behalf in my best interest as he or she considers to be in my best interest. 3. I reserve the right to revoke this power of attorney, and this power of attorney will be automatically revoked upon my death, or the death of my attorney-in-fact. 4. This power of attorney shall not be affected by either my current or future disability or incapacity. ______________________________ Signature of the Grantee
State of Alabama County of Tuscaloosa The Grantee named above came before me personally, and under oath, stated that he/she is the person described in this document, and in my presence signed this document for immediate consideration. ______________________________ Notary Public, In and for the County of _____________________________ State of _______________________ My Commission expires: __________________
I Sarah Somebody do hereby accept my appointment as attorney-in-fact. ______________________________ Signature of attorney-in-fact