Deborah Smalley CLERK OF COURTS FAIRFIELD COUNTY, OHIO POWER OF ATTORNEY

Erasures and alterations void this instrument This instrument void after sixty days from date hereinKnow All Men By These Presents, that I, the undersigned, do hereby make,
constitute and appoint

   Name __________________________________________________     


   Address _______________________________________________

My true and lawful attorney-in-fact for the following described motor vehicle, to-wit:


   Make______________ Year__________ Serial No.______________________________________________

and I hereby grant to said Attorney-in-Fact full authority to do and perform all and every act and thing whatsoever requisite, necessary and proper to be done in and about the premises as fully and to all intents and purposes as I might or could do with full power of revocation, hereby ratifying and confirming all that my named Attorney shall lawfully do or cause to be done by virtue hereof, and specifically I grant to my said Attorney-in-Fact full authority to make and execute:

(  )application for a duplicate title in my name for the above described vehicle.


                                                ______________________________________________
                                                Signature of person giving Power of Attorney

(  )application for a certificate of title in my name for the above described vehicle.


                                                ______________________________________________
                                                Signature of person giving Power of Attorney

(  )the assignment for transfer of title for the above described vehicle from my name to


        ____________________________________

                                                ______________________________________________
						Signature of person giving Power of Attorney

STATE OF OHIO, COUNTY OF FAIRFIELD, SS:

    Before me, a Notary Public in and for said State, personally appeared _______________

___________________________________________________________________, the Grantor of this Power
of Attorney, and acknowledged that he/she did sign the within instrument and that the signing of
same is of his/her own free act and deed.
        In Testimony Whereof, I have hereunto set my hand and affixed my notarial seal on this


______________day of _______________, 19_____.


                                        __________________________________________


                                        Notary Public in and for _________________
                                        County, Ohio. 	    My Commission Expires:


                                        __________________________________________