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a � �, • <br />201108699 <br />party for any claims that arise against the third party because of reliance on this power of <br />attorney. <br />Signed this �� day of ��1�����s�� 20 11 <br />, �/ <br />�` 555-26-8187 <br />:� <br />(Your agnature) � (Your Social Security Number) <br />CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC <br />STATE OF — i <br />COUNTY OF <br />ocument was acknowledged before me on 1 � [Daate] by <br />� �f - �,��� �' �,,� �. __ name of principal]. <br />Notary Public for the State of ��i�/�I��:��� <br />My commission expires: �/,����, / <br />ACKNOWLEDGMENT OF AGENTS <br />BY ACCEPTING OR ACTING UNDER'fI� APPOINTMENT, TII� AGENT ASSUMES TI� <br />FIDUCIARY AND OTHER LEGAL RESPONSIBILITIES OF AN AGENT. <br />Sherry Louise Ge' (Typed or Printed Name of Agent) <br />�'" r <br />� (Siguature of Agent) <br />Steve Roger Franke, Sr. (Typed or Printed Name of Agent) <br />(Signature of Agent) <br />. WITNESS: <br />Signature: `�rtx��. � uQco„� ) <br />�tea �� �a � w � I s a�-. n�: ��//z� /i <br />Address: 122z...1 ,�rS h�T Duerla�� �rl� 14S GG10 �' <br />Signature: �r�.j �(. CS�,.�e <br />Printed name: �� „1 �. D/� ��. Date: `� 6 <br />Address; �� � � S �l t a- t #►1 s f ►.a� �c. �s.�u ��e � �5��9 <br />Page 8 of 6 <br />Legal and Business Forms by Legal Helpmate Corp. - www.legalhelpmate.com <br />