Fillable Printable Military Power of Attorney

Military Power of Attorney

This is a military power of attorney prepared and executed pursuant to Title 10, United States Code, Section 1044b by a person authorized to

receive legal assistance from the military services. Federal law exempts a military power of attorney from any requirement of form, substance,

formality, or recording that is prescribed for powers of attorney by the laws of any state, commonwealth, territory, district, or possession of the

United States. Federal law specifies that a military power of attorney shall be given the same legal effect as a power of attorney prepared and

executed in accordance with the laws of the jurisdiction where it is presented.

SPECIAL POWER OF ATTORNEY

KNOW ALL PERSONS BY THESE PRESENTS:

That I, ___________________________________________________________, a legal resident

of the State of ______________________________________, and an active duty member of the

United States Armed Forces, social security number being ______ - ____ - ________, by this

document do make and appoint, _________________________________________________ as

my true and lawful attorney-in-fact to do and execute any or all of the following acts or things:

To execute and deliver all necessary forms, papers, certificates and receipts necessary to

file a claim against the U.S. Government under the Military Personnel and Civilian Employee

Claims Act, or any other relevant statute, for damage to my personal property, to execute any

settlement thereof, and to take possession of any monies offered in settlement thereof.

I HEREBY GIVE AND GRANT to my said attorney-in-f act full power and authority to

perform every act and thing whatsoever that is necessary or appropriate to accomplish the

purposes for which the power of attorney is granted, as fully and effectually as I could do if I

were present; and I hereby ratify all that my said attorney-in-fact shall lawfully do or cause to be

done by virtue of this document.

FURTHER, I do authorize my aforesaid attorney-in-fact to execute, acknowledge and

deliver any instrument under seal or otherwise, and to do all things necessary to carry out the

intent hereof, hereby granting unto my said attorney-in-fact full power and authority to act in

concerning the premises as fully and effectually as I may do if personally present.

PROVIDED, however, that all business transacted hereunder for me shall be transacted in

my name, and that all endorsements and instruments executed by my said attorney-in-fact for the

purpose of carrying out the foregoing powers shall contain my name, followed by that of my said

attorney-in-fact and the designation “attorney-in-fact”.

UNLESS SOONER REVOKED OR TERMINATED BY ME, this Power of Attorney

shall become NULL and VOID from and after the ______ day of ____________________,

________.

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IN WITNESS WHEREOF, I have hereunto set my hand and seal this ______ day of

____________________, ________.

____________________________________

Signature

STATE OF _____________________________ )

)

CITY/COUNTY OF _______________________ )

On this ______ day of ____________________. ________, before me,

____________________________________, and who is known to me to be the person whose

name is subscribed to the within Special Power-of-Attorney and acknowledged that he/she

executed the same for the purposes therein contained, as his free act and deed.

Sworn to and subscribed before me this ______ day of ____________________,

________.

______________________________

Notary

My Commission Expires:

(NOTE: Have this form notarized, if possible, otherwise have the form witnessed)

______________________________

Witness

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