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POWER OF ATTORNEY MUST BE SIGNED AND
NOTARIZED
LIMITED POWER OF
ATTORNEY
TO WHOM IT MAY CONCERN:
THAT, ON THE_____________ DAY
OF _______________________________, 20_______
(Company
Name) (Physical Address
of Company)
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DOES HEREBY MAKE AND APPOINT SHIRLEY MURPHY,
DEBORAH BELANGER, LYDIA STRONCHECK, AND PATTI HOLBROOKS OF ROAD LEGAL, INC., 1900
TEXAS AVENUE, (P.O. BOX 100) BRIDGE CITY, TX 77611, AGENT TO PREPARE, SIGN AND
FILE CARRIER APPLICATIONS AND/OR CANCEL ACCOUNTS FOR THE FOLLOWING: FUEL
DECALS, CAB CARDS, PERMITS, IFTA, FUEL TAX RETURNS, FEDERAL HIGHWAY
ADMINISTRATION AUTHORITY AND REGISTRATION, SSRS, EXEMPT BINGO STAMPS,
INTRASTATE AUTHORITY, FORM 2290, FORM SS4, PUBLIC UTILITIES COMMISSION'S
STAMPS, DOT NUMBER AND/OR VEHICLE REGISTRATION AS REQUIRED OF MOTOR CARRIERS BY
THE VARIOUS STATES OF AMERICA AND PROVINCES THROUGHOUT CANADA. |
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*****THIS POWER OF ATTORNEY WILL REMAIN IN FULL FORCE UNTIL***** **********FURTHER WRITTEN NOTICE FROM ROAD LEGAL, INC.*********** __________________________ SUBSCRIBED AND SWORN TO BEFORE ME,
(Authorized Signature)
THIS _____ DAY OF _________________ 20____
_________________________________________ __________________________ ( Notaries Signature) (Title) Date Commission Expires
______/______/______ ALL PARTNERS MUST SIGN IF
PARTNERSHIP _________________________
_________________________ (Partner's Signature) (Partner's
Signature) _________________________
_________________________ (Partner's Signature) (Partner's Signature) Rev. 20030415 |