Code of Federal Regulations Title 32. National Defense 32 CFR Pt. 623, App. F—Power of Attorney (DA Form 4881–4–R)

Know all men by these presents, that the (a)__________ is a (b) having its principal office in the city of (c)__________ State of (d)__________, does hereby constitute and appoint the finance and accounting officer, (e)__________, acting for and on behalf of the (f)__________, and his successors in office, as attorney for said (a), or its authorized representatives, for and in the name of said corporation to collect or to sell, assign, and transfer certain US Treasury bonds described as follows:

(g)______________________________________________

due (h)_________________________________________.

Such Treasury bonds have been deposited by (a)__________, pursuant to authority conferred by section 1126 of the Revenue Act of 1926, as amended, and subject to the provisions there of and of Treasury Department Circular No. 154, dated February 6, 1935, as security for the faithful performance of any and all of the conditions or stipulations of a certain agreement entered into by (a)__________ with the United States, under date of (i)__________ which is hereby made a part hereof as Inclosure 1. The undersigned agrees that, in case of any default in performance of any of the conditions and stipulations of such or any part thereof the finance and accounting officer (e)__________ may sell, assign, and transfer said Treasury bonds or any part thereof without notice, at public or private sale, free from equity of redemption and without appraisement or evaluation, notice of right to redeem being waived, and may apply the proceeds of such sale or collection in whole or in part, to the satisfaction of such default. The undersigned further agree that the authority herein granted in irrevocable.

And such (a)__________ hereby for itself, its successors and assigns, ratifies and confirms such proper action taken within the scope of this power.

In witness whereof, the (a)__________, the (b) herein above named by its (j)__________ and (k)__________ duly authorized to act in the premises, has executed this instrument and caused the seal of the (a) to be affixed this (l)__________ day of (m)__________ 19 (n)____

(a)_____________________________________________

By: (o)__________________________________________

By: (p)__________________________________________

(Name and title)

(Name and title Comptroller)

Before me, the undersigned, a Notary Public within and for the County of (q) in the State of (r)__________, personally appeared (s)__________, (j), and (p), comptroller, and for an on behalf of said (a), a (b)__________, acknowledged the execution of the foregoing power of attorney.

Witness my hand and notarial seal this (l)_______ day of (m)_______, 19(n)____.

Notarial Seal (t)________________________________

(Notary Public)

DA FORM 1 MAY 80 4881-4-R

Note. The above lettered blank portions of the sample power of attorney are to be completed as specified in the following paragraphs with the same letters:

(a) Enter the name of the Federal agency, authority, (local governmental body), or special activity which borrowed the Army materiel.

(b) Further identify the borrower by entering here the type of activity that it is; i.e., Federal agency, civil government, corporation (Boy Scouts of America), etc.

(c) Enter the name of the city.

(d) Enter the name of the state.

(e) Enter the name of the Army installation handling the account.

(f) Enter the name and rank of the commanding officer of the Army installation handling the account.

(g) Describe the US Treasury bonds that have been posted as bond to include type, serial numbers, and interest rates if applicable.

(h) Enter date on which payment of the Treasury bonds becomes due if applicable. If it is not applicable enter “NA.”

(i) Enter the date on which the agreement between the borrower and the US Government was signed.

(j) Enter title of the borrowing activities' chief executive; e.g., governor, chief scout executive, national commander VFW, etc.

(k) Enter here, “Comptroller,” “Treasurer,” etc. as appropriate.

(l) Enter date on which the Power of Attorney is signed.

(m) Enter month in which power of attorney is signed.

(n) Enter year in which power of attorney is signed.

(o) Enter name and title of chief executive of borrowing activity.

(p) Enter, if appropriate, the names and title of the comptroller or treasurer of the borrowing activity.

(q) Enter the name of the county in which the power of attorney is being signed.

(r) Enter the name of the State in which the Power of Attorney is being signed.

(s) Enter the name of the chief executive of the borrowing activity.

(t) Signature of the Notary Public.