STATE OF ALASKA )
______________ JUDICIAL DISTRICT )
On this ___________ day of __________ , 20 _______ , before me the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn personally appeared _________________________ , to me known to be the individual who executed the foregoing instrument as attorney in fact of __________________________ therein described, and acknowledged to me that ____ he signed and sealed the said instrument as such attorney in fact for said principal, freely and voluntarily, for the uses and purposes therein mentioned, and on oath stated that the power of attorney authorizing the execution of this instrument has not been revoked and that the said ____________________________ is now living.
WITNESS my hand and official seal hereto affixed the day and year in this certificate above written.
Notary Public in and for the State of Alaska My commission expires: _________________
No guidelines are available for this form at this time.