Vehicle Motor Vehicle Power of Attorney Form

VEHICLE POWER OF ATTORNEY

I. THE PARTIES. This Vehicle Power of Attorney made this ______________________, 20____, is by and between:

Principal: ______________________ and a mailing address of ____________________________________________ who grants power of attorney to:

Agent: ______________________ with a mailing address of ____________________________________________ who accepts such powers and agrees to act on behalf of the Principal.

II. THE VEHICLE. The Principal agrees to grant power of attorney for the following:

Make: ______________________ Model: ______________________ Year: ______________________ Style: ______________________ VIN: ______________________

III. POWERS GRANTED. The powers granted by the Principal include registration with the state and local authorities, change of ownership, titling of the vehicle, and any other related responsibilities. Such powers shall be for an indefinite period of time unless terminated by the Principal.

IV. EXECUTION.

Principal's Signature: ______________________ Date: ____________

Date of Birth: ______________________

If an individual, Social Security Number: _____-_____-_______

If an entity, Federal EIN: ____-__________

NOTARY ACKNOWLEDGMENT

STATE OF ______________________ )

COUNTY OF ______________________ ) ss.

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

On ______________________, before me, ______________________ (insert name and title of the officer), personally appeared ______________________, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of ______________________ that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature: ______________________

Print Name: ______________________

(Seal)

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