BE IT KNOWN, that _____________________________________ has
made and appointed, and by these presents does make and appoint 
_______________________________ true and lawful attorney for
him/her and in his/her name, place and stead, for the following
specific and limited purposes only: 

giving and granting said attorney, full power and authority to
do and perform all and every act and thing whatsoever necessary
to be done in and about the specific and limited premises (set
out herein) as fully, to all intents and purposes, as might or
could be done if personally present, with full power of
substitution and revocation, hereby ratifying and confirming all
that said attorney shall lawfully do or cause to be done by
virtue hereof. 

     IN WITNESS WHEREOF, I have hereunto set my hand and seal
this _______ day of _______________________, 19____. 

Signed, sealed and delivered in the presence of: 

_____________________________      _____________________________


State of _____________ )
                       ) ss.
County of ____________ )

     The foregoing instrument was acknowledged by me this ______ 
day of _____________, 19 ____ by:_______________________________
who is/are personally known by me or who has/have produced:_____
______________________ as identification and who did not take an 

                         ________________________________ (SEAL)
                         Notary Public 
                         State of
My Commission Expires: