Letterhead of Investor
LIMITED POWER OF ATTORNEY
I(WE) __NAME OF THE INVESTOR___ WITH LEGAL ADDRESS AT ______ HEREWITH
GRANT A LIMITED POWER OF ATTORNEY TO: ________________________________________________
THIS LIMITED POWER OF ATTORNEY AUTHORIZES _____________________________
TO DISCUSS, NEGOTIATE AND FINALIZE THE TERMS AND CONDITIONS OF AN INVESTMENT PROGRAM WITH
OUR FUNDS BLOCKED FOR THE PURPOSE IN:
| NAME OF BANK: |
ABA NUMBER: |
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| BANK'S ADDRESS: |
ROUTING NUMBER: |
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| ACCOUNT NAME: |
TELEPHONE NUMBER: |
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| ACCOUNT NUMBER: |
FACSIMILE NUMBER: |
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| BANK OFFICER: |
S.W.I.F.T. CODE: |
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| TITLE BANK OFFICER: |
TELEX NUMBER: |
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OR SUBSEQUENTLY BLOCKED IN ANOTHER FINANCIAL INSTITUTION TO BE
DESIGNATED BY_______NAME________, AND THAT SUCH FUNDS SHALL REMAIN BLOCKED FOR A FURTHER
PERIOD OF THE (10) INTERNATIONAL BANKING DAYS TO ENABLE OUR ABOVE NAMED ATTORNEY-IN-FACT
TO VERIFY AND CAUSE TO BE VERIFIED THE SAID BLOCKING OF INVESTABLE FUNDS AND PLACE THE
SAME IN AN APPROPRIATE INVESTMENT PROGRAM.
TO FINALIZE ALL NECESSARY REQUISITES TO ENABLE US TO HAVE AN INVESTMENT
ACCOUNT OPENED IN A BANK IN --------COUNTRY--------,SHOULD WE CHOOSE TO DO SO, WHICH SHALL
BE OPERATED BY US, AND TO DO ALL SUCH ACTS AND DEEDS FOR OPENING SUCH AN ACCOUNT FOR WHICH
WE HAVE FURNISHED THE NECESSARY REQUIREMENTS OF SAID BANK WHERE OUR ATTORNEY-IN-FACT SHALL
CAUSE AN ACCOUNT TO BE OPENED, ALL INSTRUCTIONS IN THIS REGARD GIVEN TO THE BANK BY OUR
SAID ATTORNEY-IN-FACT FOR US ON OUR BEHALF SHALL BE HONORED BY US.
WE FURTHER AGREE TO CONDONE ALL ACTS AND DEEDS DONE AND EXECUTED BY THE
ATTORNEY-IN-FACT FOR US AND ON OUR BEHALF IN A GOOD AND FAITHFUL EXERCISE OF THESE POWERS
AS IF THE SAME WERE DONE AND EXECUTED BY US PERSONALLY.
IN WITNESS WHEREOF WE PUT OUR HANDS ON THIS____DAY OF_____, +ÍÍÎ, IN
PRESENCE OF A PUBLIC NOTARY, UNDER OATH OF AN AFFIDAVIT, AND CONFIRM, THAT THESE POWERS
SHALL REMAIN IN FULL FORCE FOR A PERIOD OF ONE YEAR AND TEN DAYS FROM THE DAY AND DATE
HEREIN ABOVE MENTIONED UNLESS OTHERWISE EXTENDED.
BY:___________ TITLE:_______
CORPORATE SEAL__________ |