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I, , do hereby appoint my ,
, with full power of substitution (herein called
"my attorney-in-fact"), my true and lawful attorney-in-fact, to represent and act for me for and
during the period commencing . In the event that she is deceased or
otherwise unable to serve as my attorney-in-fact, I hereby appoint my ,
, to serve as my true and lawful attorney-in-fact. These
powers granted in this instrument are effective until revoked by me in writing. The powers herein
and hereby conferred are general and my attorney-in-fact is by this power fully authorized to act
in all matters and affairs in my place and stead.
This power of attorney is executed for the purpose of expediting the transaction of all personal,
business and investment affairs of mine and to permit action in my name and in my behalf with
respect to any and all my property and affairs during the period of this power as fully and
effectively as I might do were I present and acting, third persons being relieved of the
responsibility to determine, or to require compliance by my attorney-in-fact with, my instructions.
In extension and not in limitation of the powers given by other provisions of this instrument, I
confer upon my attorney-in-fact the power to do all things deemed necessary or proper to carry
out the provisions and intent of this power of attorney, including but not limited to the following
powers, all of which may be exercised from time to time at his discretion and with respect to
property in which I now or hereafter have any interest:
(a) To sell, to exchange, to lease, to make contracts or to grant options concerning or otherwise
transfer or dispose of any of my real or personal property at public or private sale without
advertisement, or through any exchange or dealer and with respect to securities to authorize their
transfer upon the books of the respective companies, for such consideration and upon such terms
as to credit or otherwise as my attorney-in-fact may determine, which leases, contracts and options
may extend beyond the expiration of this power;
(b) To invest in, purchase or otherwise acquire in my name stocks, shares and obligations of
corporations, unincorporated associations, trust, investment companies, mortgages, notes, choses
in action, real estate, improvements thereon, and other personal and real property as such attorney-
in-fact may deem best without regard to any law now or hereafter in force limiting investments
for any fiduciary;
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(c) To vote in person or give general or limited proxies or powers of attorney for other voting or
acting in respect of any of my corporate stock or other security, which may be discretionary and
with power of substitution; to consent directly or through a committee to any reorganization,
recapitalization, merger, consolidation, dissolution, amendment to articles of incorporation,
liquidation, bankruptcy or other procedures or proceedings affecting any corporation in which I
have any interest, and to any sale, lease, pledge or mortgage of any property by or to any such
corporation; and to make any payments, assessments or subscriptions and to take any steps my
attorney-in-fact may deem necessary and proper to enable him to obtain the benefit of any such
(d) To employ brokers, accountants, attorneys, investment counsel; custodian of trust property
and other agents;
(e) To compromise, compound, submit to arbitration, sell, release, settle or adjust any claims or
demands by or against me which I now or hereafter have, and to agree to any rescission or
modification of any contract or agreement affecting me or any property;
(f) To complete, extend, modify or renew any indebtedness of mine as well as to borrow money
and execute notes obligating me, and to secure the same by mortgaging, pledging, conveying or
otherwise encumbering any or all of my property;
(g) To improve or develop real estate; to construct, alter or repair buildings or structures on real
estate; to settle boundary lines and easements and other rights with respect to real estate; to
partition and to join with co-owners and others in dealing with real estate in any way;
(h) To receive and receipt for any property or money which I am or may be entitled to receive
and to hold, handle and deal with such property;
(i) To draw and sign, endorse, deposit or otherwise collect checks on any of my bank accounts
and other instruments for the payment of money;
(j) To execute in my name, seal and deliver any and all instruments in writing deemed advisable
to carry out any of the foregoing powers and no one dealing with my attorney-in-fact need inquire
into the validity of anything he does or need see to the application of any money paid or any
property transferred to or upon his order;
(k) To represent me before any office of the Internal Revenue Service with respect to any Internal
Revenue Service tax matter and for any year or period;
(l) To represent me before any State of Georgia Department of Revenue office or the office of
any tax or licensing official of any political subdivision of the State of Georgia with respect to
any Georgia or such political subdivision tax matter and for any year or period; and
(m) To receive confidential information and full power to perform on my behalf the following
acts with respect to the above matters; and,
(n) To receive, to endorse and collect, checks in payment of any refund of any taxes, penalties,
or interest; to execute and file on my behalf all income tax returns, claims for refund, protests,
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and declarations of estimated tax, whether Federal or State; to execute waivers (including offers
of waivers) of restrictions on assessment or collection of deficiencies of tax refund; to execute
consents extending the statutory period for assessment or collection of taxes; to execute closing
agreements under Section 7121 of the Internal Revenue Code; to delegate authority or to substitute
another representative.
Copies of notices and other written communications addressed to me in proceedings involving
the above tax matters should be sent to my attorney-in-fact at any address which he may specify.
The enumeration of specific powers herein shall in no wise limit the general power and authority
of my attorney-in-fact hereunder; and the expiration of the period of agency hereunder shall in
no way affect the validity of his actions during said period;
All parties dealing with my attorney in-fact in connection with my affairs may fully rely upon his
power and authority to act for me and in my behalf and in my name, and may accept and rely on
agreements entered into by him pursuant to this power of attorney.
In addition to, and not in limitation of the above powers, including any powers that may be
incorporated by reference pursuant to OCGA Section 53-12-232, my attorney-in-fact shall have
the following powers:
To sell, exchange, partition or otherwise dispose of any property or interest therein from time to
time at public or private sale, with or without advertisement, upon such terms and conditions,
including credit, as my Attorney-in-fact shall deem advisable;
To improve, repair, or lease (as lessor or lessee) any real or personal property and to grant or
receive options to purchase property; and a lease or option may be made for a term which may
extend beyond the duration of the Trust or the administration of my estate;
Without limitation, to retain any property owned by me, including any stock in a corporate
Fiduciary; to invest in stocks, whether common, preferred or otherwise, bonds, loans, securities,
interests in partnerships, or other property, real or personal, or in any common trust fund of a
corporate Fiduciary; to register any securities in their own names, or in the names of nominees,
with or without indicating the fiduciary character of such investments; and to vote any stock by
themselves or by proxy; it being my intention to give my Attorney-in-fact the same investment
powers which I possess with respect to my own funds;
To acquire, receive, and retain investments without regard to principles of diversification, and
without regard to the predominance of common stock, or stock in closely held corporations;
To enter into any plan or agreement for the sale, merger, consolidation, liquidation,
recapitalization, or other disposition of any trust or estate property, or of any corporation issuing
securities held as part of my estate or any trust; and to accept in such transactions any cash,
securities, or property that my Attorney-in-fact deems proper; and,
To operate and continue any and all businesses, including proprietorships and partnerships, in
which I may have an interest at the time of my death; to acquire additional interests in any such
businesses; to liquidate or join in the liquidation of any such businesses; to sell or otherwise
dispose of the same as going concerns; to incorporate or cause to be incorporated as they shall
see fit, and to retain stock in any such businesses so incorporated without liability for
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depreciation in value; to become or remain a general or limited partner in any new or continuing
partnership and to take such other action as they may deem necessary or proper for the purpose
of beginning or continuing the operation or liquidation of such businesses; to act as directors,
officers, or employees of any such businesses, and receive reasonable compensation therefore;
and to take all appropriate actions to prevent, identify or respond to actual or threatened violations
of any environmental law or regulation there under.
Print Name
Sworn to and subscribed
Notary Public My Commission expires:
before me, this
day of , 20 .
This Power of Attorney shall be effective and valid at all times from the signing thereof until it is
revoked by signing below.
Print Name:
Sworn to and subscribed
Notary Public My Commission expires:
before me, this
day of , 20 .
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